U.S. CONGRESSMAN SAM JOHNSON
Third Congressional District of Texas
Middle School Patriotic Essay Contest
“ What America means to me ”
Contest Guidelines
· The contest is open to all middle school students who live in the Third Congressional District of Texas.
· Essays should be 400-500 words.
· Entries must be typed and double spaced.
· A completed Student/Parent Release Form MUST be submitted with the essay (attached).
· Students may not identify themselves, their school, or their parents within the essay.
· Quotations must be identified with adequate citation and the use of either quotation marks or indentation.
· Essays must be submitted with a coversheet including the following information:
Student’s Full Name
Title of Essay
School
Teacher
Grade Level
· Entries may be submitted by mail or fax to my district office:
Congressman Sam Johnson
2929 N. Central Expwy, Ste. 240
Richardson, TX 75080
(972) 470-9937 fax
You may also email entries to . If you would like the essays picked up at your school, please notify my office at least 2 days prior to the contest deadline.
For more information , please contact Deanna Kuykendall at (972) 470-0892.
U.S. CONGRES S MAN SAM JOHNSON
Third Congressional District of Texas
Middle School Patriotic Essay Contest
“ What America means to me ”
Student/Parent Release Form
Student’s Name: _________________________________________________________________ Grade: ___________
Street Address: ___________________________________________________________________ Age:_____________
City: _____________________________________________________ State: ___________ Zip: _________________
Parent/Guardian Name: ______________________________________________________________________________
Daytime Phone: ____________________________________ Evening Phone: __________________________________
Teacher Name: _________________________________________ Daytime Phone: _____________________________
School: ___________________________________________________________________________________________
School Address: ____________________________________________________________________________________
City: _____________________________________________________ State: ___________ Zip: _________________
I, __________________________ ______ _______ ( s tudent’s f ull n ame), testify the essay submitted is an original work of authorship personally created. I hereby grant permission to U.S. Congressman Sam Johnson and his staff, the House of Representatives and any other public or private entity the use of my name, name(s) of parent(s), city of residence, school, teacher, grade level, photographic image and written materials in regards to Congressman Sam Johnson’s Patriotic Essay Contest. I understand this release constitutes consent for any lawful purpose whatsoever in any and all forms of media. I unde rstand that by signing this form no further authorization is needed to release information.
____________________________________________________________ ________________________________
Student’s Signature Date
____________________________________________________________ _______________________________
Parent/Guardian Signature (required) Date
____________________________________________________________ ________________________________
Teacher’s Signature Date