| The
Dorchester Day |
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Print out this form to enter |
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Please print clearly:
Student's Age:
Student's Name
Current grade the student is enrolled in:
5th Grade
9th Grade
6th Grade
10th Grade
Dorchester, Ma
7th Grade
11th Grade
8th Grade
12th Grade
By
submitting this form:
I allow the Dorchester Celebrations Committee to publish a picture and submit the winners name in the local newspapers.
February 28, 2003 to:
74 Pleasant Street
Dorchester, Ma 02125
I am over 18 and hereby allow the child above to enter the essay contest.
X
Parent/Guardian Signature
Date