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