Joan Yen Memorial Youth Art Contest – 2016Artist’s Submission Form

(Entry deadline: April 24 2016, 12:00 P.M. NOON)

Artist抯 name (please print): _______________________________ Date of Birth: ______________

Artist抯 Home address: Artist抯 Email address (if any):

____________________________________ ________________________________________

____________________________________

School Name: ________________________

Prefer Location: PHX or Chandler (select one)

Artist抯 category (check one): Under age 6( ) Age 7-9 ( ) Age 10-12 ( )

Age 13-15 ( ) Age 16-18( )

Submitted by (check one): Teacher ( ) Parent ( ) Guardian ( )

Teacher, Parent or Guardian抯 name: (Please Print) ________________________________________

Teacher, Parent or Guardian抯 signature: _________________________________________________

By signing above, and as the Teacher, Parent or Guardian of the artist/entrant, I certify that the information provided is accurate and that the submitted work of art was created by the artist/entrant. I further certify and agree that although the work of art shall be the property of the artist/entrant except if ultimately abandoned as noted below, if the submitted work is selected as a contest winner, including honorable mention, the artist hereby grants the contest organizer, Chinese United Association of Greater Phoenix (Chinese United, license and authority, for a period of up to one year, to use the submitted work of art as well as the artist’s name and likeness for a variety of purposes including their reproduction and publication in Chinese United publications and exhibition at Chinese United functions, including, but not limited to the Fourth of July or the Phoenix Chinese Week Festivities.

Teacher, Parent or Guardian’s Phone number ( ) _______________________________________

Teacher, Parent or Guardian’s email address: ______________________________________________

(Those artists whose work is not selected as a winner or for honorable mention, may retrieve their submissions during ordinary business hours between July 11th to July 31st from the location where they were originally submitted. All work not so retrieved by July 31st may be donated by Chinese United or otherwise disposed of at the discretion of Chinese United. For more information or questions, please contact: Vice President David Cui ?cuizq@hotmail.com