Poetry Competition Entry Form

Entry Form for the Lions Poetry Competition

(Note: Only use the School Year)

Student's Name .................................................................... School Year ........

Name of School ...........................................................................

Parent's Name .....................................................................................................................

Contact Address ..................................................................................................................

Town ................................................ Post Code ....................... Telephone ......................

I certify that the attached Poem is solely the work of ............................................................................

I agree to the poem being used by the Lions Clubs to promote the work of Lions in the community.

Signed .................................................................. (Parent or Guardian) Dated ......................................

The attached Poem (Entitled) ...................................................................................... does not have the authors name showing.

(Note: Lions clubs will give the entry a reference number marked on bottom of the poem and maintain a list of all entries for the purposes of judging)

For Lions Club use:

Title ...............................................................................

Lions Club of .............................................................................. Entry Ref No .........................

President ...........................................................................

Contact Name/Youth Officer ..............................................

Contact Telephone ............................................................

Contact e-mail ..........................................................................................

Lions Poetry Competition: 2018-2019

Theme:'Homelessness'