OFFICIAL ENTRY FORM 2015 Tribal College Student Writing, Art

OFFICIAL ENTRY FORM
2015 Tribal College Student Writing, Art, and Film Competition
A separate form must accompany each entry (fiction, nonfiction, poem, artwork, or film)
Postmark deadline: February 13, 2015 (writing competition) or April 17, 2015 (artwork and film
competitions)
1. Student’s name: _____________________________________________________________
Note how you want your name printed on Winners List/Certificate, if different from above:
___________________________________________________________________________
2. Student’s mailing address:
____________________________________________________
____________________________________________________
3. Student’s phone number: (______) ____________________
4. Email:________________________________
5. Student’s tribal college: ____________________________________________________________________
6. TITLE of entry: _________________________________________________
Page count (for writing entries):___________________ Duration (for film entries): ______________________
7. FIRST LINE of entry (for writing entries):
________________________________________________________________________
8. Check Division/Category of this entry:
Fiction
Nonfiction
Poetry
Artwork
Film
9. Attach a 100-word biographical statement (include your tribal college and major, any tribal affiliation,
aspirations or interests, any credits to mentors, and information about your interest in writing/art/film). If your
entry is selected, we will request your photo.
10. Name of Writing/English/Art/Film/Other Instructor (who has reviewed the entry):
________________________________________________________________
11. Instructor’s telephone number: (
) ______________ and email address:___________________________
12. Student Consent and Warranty:
If your work is selected as a winner or an honorable mention, Tribal College Journal reserves the right to edit for
grammar, spelling, possible word replacement or reformatting, if necessary. We also reserve the right to
restructure or delete some sections of text for readability or to preserve internal consistency of narrative. If your
entry requires substantial changes, our copy editor will contact you directly for suggested changes. As our call for
entry indicated, each entry is limited to a 1,000 word count maximum.
By submitting your artwork, writing, and/or film, you acknowledge Tribal College Journal’s right to use all
customary means to publish and distribute the work, including not only within the TCJ magazine and website but
also through various on-line services, digital editions, social networking sites, and mobile digital applications.
The student certifies that this writing/artwork/film is original and that the author/artist/filmmaker has the authority
to make this agreement. The student also certifies that the writing/artwork/film does not infringe upon any
copyright or contain any libelous or unlawful matter.
________________________________________
Student’s Signature
13. Send entry form with entry by email to: [email protected]
Tribal College Journal ▫ tel (970) 533-9170 ▫ P.O. Box 720, 130 E. Montezuma ▫ Mancos, CO 81328