Poetry Contest Submission Form
East Lake Mini Library Annual Poetry Contest

Fill out the required information and then follow the steps to upload your work in PDF or Microsoft Word format. If you provide an email address, you will receive a copy of the submission email for verification that your entry was sent. Each person may submit up to 10 poems.

* denotes a required field.

Release/Entry Form

* Name:	* Please provide First Name.
* Mailing Address:	* Please provide your address.
* City:	* Please provide city.
* State:	* Please provide state.
* Zip:	* Please provide zip.
* County:	* Please provide county.
* Phone:	* Please provide your phone number.
E-mail:	Please enter a valid email address.
Age Group:	Select... Children's Group (0-12) Teen Group (13-18) Adult Group (19 and up) * Please select Entry Group
Please provide the following if under 18 years old:
Parent/Guardian Name:
Parent/Guardian Phone:
Please provide a name for the file you are uploading. This helps us retrieve it from our server. Files must be a PDF (.pdf) or WORD (.doc, .docx) document.
Document Name:	* Please provide name for your entry's file.
Upload Your File:
Terms and Agreement for Online Sumission
Submission of this form is equivalent to submission of a hard copy of the release form. Checking the box below is equivalent to your signature of the hard copy of the release form. Checking the box below and submitting the form constitutes a release to reprint the attached work for public distribution and to display it in the Lake County Library News, Official Website and other library publications. This is a free service to residents, therefore the County cannot compensate the author. If your work is selected, you will be contacted with specific information. Submission of work does not guarantee publication. Any entries received after the first ten will be discarded.
Check this box to acknowledge that you have read and accept the terms stated above.