New Hampshire State House Bicentennial Commission

Essay Contest Entry Form

(Ages 5-11 - equivalent to Kindergarten through Elementary School)

Please type or print clearly.

1.STUDENT INFORMATION

Name:______

Teacher Sponsor Name:______

School Name:______

Essay Title:______

Age:______Birth Date:______

School: ______

Phone:______E-Mail:______

Home Street Address:______

City, State:______

Postal or ZIP Code:______

Parent or Legal Guardian Signature:______

By entering the contest, participants agree to be bound by the contest rules and the decisions of the judges. Participants accept all responsibility for late, lost, misdirected or illegible entries. Entries sent by mail with insufficient postage will be disqualified. Entries will not be returned; however, arrangements can be made. Essay contest participants agree to allow the contest sponsor to use their names and artwork for promotional and publicity purposes. The essay contest may be cancelled without notice at any time. Notification will not be given to those applicants with non-winning essays. No essay will be given preference on the basis of an applicant’s school, grade, geographic origin, race, ethnicity, gender, sexual orientation, or any legally-protected status. No essay will be given preference on the basis of ability to attend the awards ceremony. Applicant acknowledges that in the administration of the essay contest the state shall have no liability as a result of errors or omissions of error.

New Hampshire State House Bicentennial Commission

Essay Contest Entry Form

(Ages 11-14 - equivalent to Middle School)

Please type or print clearly.

1.STUDENT INFORMATION

Name:______

Teacher Sponsor Name:______

School Name:______

Essay Title:______

Age:______Birth Date:______

School: ______

Phone:______E-Mail:______

Home Street Address:______

City, State:______

Postal or ZIP Code:______

Parent or Legal Guardian Signature:______

By entering the contest, participants agree to be bound by the contest rules and the decisions of the judges. Participants accept all responsibility for late, lost, misdirected or illegible entries. Entries sent by mail with insufficient postage will be disqualified. Entries will not be returned; however, arrangements can be made. Essay contest participants agree to allow the contest sponsor to use their names and artwork for promotional and publicity purposes. The essay contest may be cancelled without notice at any time. Notification will not be given to those applicants with non-winning essays. No essay will be given preference on the basis of an applicant’s school, grade, geographic origin, race, ethnicity, gender, sexual orientation, or any legally-protected status. No essay will be given preference on the basis of ability to attend the awards ceremony. Applicant acknowledges that in the administration of the essay contest the state shall have no liability as a result of errors or omissions of error.

New Hampshire State House Bicentennial Commission

Essay Contest Entry Form

(Ages 15-21 – equivalent to High School)

Please type or print clearly.

1.STUDENT INFORMATION

Name:______

Teacher Sponsor Name:______

School Name:______

Essay Title:______

Age:______Birth Date:______

School: ______

Phone:______E-Mail:______

Home Street Address:______

City, State:______

Postal or ZIP Code:______

Parent or Legal Guardian Signature:______

By entering the contest, participants agree to be bound by the contest rules and the decisions of the judges. Participants accept all responsibility for late, lost, misdirected or illegible entries. Entries sent by mail with insufficient postage will be disqualified. Entries will not be returned; however, arrangements can be made. Essay contest participants agree to allow the contest sponsor to use their names and artwork for promotional and publicity purposes. The essay contest may be cancelled without notice at any time. Notification will not be given to those applicants with non-winning essays. No essay will be given preference on the basis of an applicant’s school, grade, geographic origin, race, ethnicity, gender, sexual orientation, or any legally-protected status. No essay will be given preference on the basis of ability to attend the awards ceremony. Applicant acknowledges that in the administration of the essay contest the state shall have no liability as a result of errors or omissions of error.