Schedule/Programs

Become a Chapter

 Northwest Chapter: Washington State

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Essay Contest Registration Form

Sponsored by Women’s Federation for World Peace

Washington, DC Chapter

Deadline: All applications must be postmarked May 15, 2009

Please print or type:

NAME:_________________________________________________________________

                  Last                                                                 First                                                        Middle

HOME ADDRESS: _______________________________________________________

________________________________________________________________________

     City                                                                                  State                                                       Zip Code

TELEPHONE NUMBER: (_______) _________________________________________

CELL: (_______) _____________________ EMAIL: ____________________________

HIGH SCHOOL: _____________________________ GRADUATION YEAR: _______

ESSAY WORD COUNT: ______________

ARE YOU OR ANY MEMBER OF YOUR IMMEDIATE FAMILY A MEMBER OF WFWP?       Yes _____                   No _____

HOW DID YOU HEAR ABOUT THIS CONTEST?  ____________________________

Declaration and Consent

I confirm that the information provided on this application and attached hereto, is complete and accurate in every respect.  I authorize WFWP to reproduce this essay in any form.  I understand that my photo may be used with my essay in any publication.  I also agree to attend the awards ceremony in Washington DC on May 30.  I understand that my essay will not be returned to me. 

Parent Signature:_______________________________         Date:___________________

Student Signature: _____________________________           Date: ___________________

Attach this registration form to your essay and mail it to:

WFWP

P.O. Box 3243

Washington, DC 20010

All applications must be postmarked by May 15, 2009.  Email submissions will not be accepted.