Local Entry Form

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2015 NACD/VASWCD
POSTER CONTEST
Please
appropriate category
___K-1 ___ 2-3 ___ 4-6 __ 7-9 ___10-12
____ The poster is being submitted to earn a
Girl Scout VASWCD Poster Contest Patch
Local Entry Form
Submit poster entries to Mountain Castles Soil & Water Conservation District.
Not familiar with your local SWCD? Visit www.vaswcd.org for information.
Deadlines may vary.
Attach this registration form to the back of your poster.
STUDENT
First Name________________Middle________Last_____________________
Address_________________________________________________________
City
State
Phone (
)
Zip ______
E-mail _____________________________
School Name _____________________________ Grade ______ Age ___________
The poster is an original completed by the student.
The student received assistance from another person or materials/ideas
from another source. If so, please explain on another piece of paper.
SCHOOL
Teacher ___________________________________________________________
Public School __________ Private School __________ Home School ________
Address
Phone (
City
)___________
State___________ Zip
E-mail address______________________________________________________
Parent or guardian name (printed)_______________________________________
Signature of parent or guardian allowing NACD/District to utilize the poster for
educational or promotional purposes:
____________________________________________Date
SOIL & WATER CONSERVATION DISTRICT
SWCD:
Mountain Castles SWCD
Contact:
Tim Miller
Title: Education Coord.
Address: 36 Executive Circle, Suite 1
Phone: 540-977-2698
City: Roanoke
VA
Email:
24012
trailrunner95@gmail.com
Questions?
Contact Your Local Soil &Water Conservation District or Beth Sokolik at
(804) 559-0324 or Elizabeth.sokolik@vaswcd.org
Virginia Association of Soil & Water Conservation Districts
http://vaswcd.org/poster-contest
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