REGIONAL ENTRY FORM
Central Washington Regional Contest:
Sat., March 15, 2014 @ West Valley Jr. High / Yakima
STUDENT INFORMATION (Individual or Group Leader)
NOTE FOR GROUP ENTRIES: Group Leader completes this side of form. Enter all student information for EACH ADDITIONAL group member on reverse side of this form. Only one entry form per group. (FOR PROPER SPELLING OF NAMES, PLEASE PRINT CLEARLY.)
Name______Grade______
(Last) (First) (Middle Initial)
Home Address______
City______Zip Code______Phone (_____)______
Parent’s Name(s)______
(First and Last names)
SCHOOL INFORMATION
School Names/Address______
City______Zip Code______Phone_(___)______
Teacher’s Name(s)______
(First and Last names)
Teacher E-mail______
ENTRY INFORMATIONDIVISION __Junior (grades 6-8) __Senior (grades 9-12)
Title______
(MUST BE COMPLETED)
Category of Entry (Only check one): __Individual Performance__Group Performance
__Individual Exhibit __Group Exhibit
__IndividualDocumentary __Group Documentary
__Individual Website __Group Website
__Historical Paper
(Historical Papers due no later than February 26, 2014)
Check items needed: __Electrical Outlet __Table Space
__Projection Screen __Floor space
Sharing Materials?__Yes __No With whom?______
Website entries:Fill in the numeric portion of your website URL here:
.
This information is required so that your entry may be judged.
(Websites will be locked for judging onMonday,March 3, 2014)
I affirm that the entry submitted for competition was researched and developed by myself (and group members) during this school year. I understand that the History Day Committee and sponsors will not be responsible for loss or damage to exhibits and personal belongings during the day’s activities. I have inspected all materials submitted for completeness.
______
Individual Student or Group Leader Signature Date
______
Parent’s SignatureDate
______
Teacher’s SignatureDate
Please supply $8.00 (for each student) in the form of a checkmade out to
“Panther Parents”by February 26, 2014. Please send all materials to
West Valley Jr. High in care of Matt Norling,7505 Zier Road, Yakima, WA 98908.
**Please note that we do not take purchase orders**
Entry Checklist:______Completed Regional Entry Form for each student / group entry
______Check(s) equal to $8 for each participant made out to “Panther Parents”
______Historical Papers included, with **required materials
**see last page for explanation
______Package mailed to Matt Norling, WVJH, 7505 Zier Road, Yakima, WA 98908
STUDENT INFORMATION (Group Member 2)
Name______Grade______
(Last) (First) (Middle Initial)
Home Address______
City______Zip Code______Phone (_____)______
Parent’s Name(s)______
STUDENT INFORMATION (Group Member 3)
Name______Grade______
(Last) (First) (Middle Initial)
Home Address______
City______Zip Code______Phone (_____)______
Parent’s Name(s)______
STUDENT INFORMATION (Group Member 4)
Name______Grade______
(Last) (First) (Middle Initial)
Home Address______
City______Zip Code______Phone (_____)______
Parent’s Name(s)______
STUDENT INFORMATION (Group Member 5)
Name______Grade______
(Last) (First) (Middle Initial)
Home Address______
City______Zip Code______Phone (_____)______
Parent’s Name(s)______
Appendix: Early Entry Submission Requirements
Requirements for Historical Paper Submissions
- 4 copies of historical paper, including title page and annotated bibliography
- Completed entry form
Requirements for Website Submission
Students are required to create their projects using the NHD Web Portal. Each website has a unique URL or web address that will look something like
To enter the web site category, students must:
- Use the NHD Web Portal to create their site;
- Include all “paperwork” items (title page, process paper, and annotated bibliography) as a part of their actual website.
- Include specific website URL on their entry form (see above).
- Note that all websites will be “locked” for judging on Monday, March 3. Between that date and March 15 (Regionals), no changes will be allowed. Sites will be unlocked following Regionals for those moving on to State.