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Entry Form

 

This form should be securely fastened on the back of each photo submitted.
Please PRINT.

Name:______________________________________________________________________

Mailing address:______________________________________________________________

City/State/Zip:________________________________________________________________

Phone: ___________________ E-Mail:____________________________________________

Group (please circle) Kids (12 and under) -- Teens (13-18) -- Adults (over 18) -- LUMCON Employee

Title of photo:




Location, time of day, and circumstances under which photo was taken:




Describe how the photo depicts the theme: