Please print legibly or type.
Student's Name: ________________________________________
Home Phone: (_____) ________________
Student Grade Level (circle one): 1 2 3 4 5 6
School: ______________________________________________
Teacher: ___________________________________
Teacher's Phone number (_____) ________________
Deadline March 30, 2001 (postmark)
1st, 2nd and 3rd place prizes will be awarded to both age categories (grades 1-3 and grades 4-6).
Please mail the Entry Form with the essay to MADD at the address above.
This page is http://www.maddorangecounty.org/essay2001/form.htm
Page updated: December 19, 2003