2006 Wild Ones Photo 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 ___________________________________________________________

Wild Ones Chapter Affiliation ____________________________________________
(If not a member of a chapter, indicate PAL for partner-at large.)

Photo Category: I am entering:

Adult Photo Category ______________________________________________

Kid's Photo Category _______________________________________________

Title of Photo _______________________________________________________

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

__________________________________________________________________


Optional:

Type of camera ____________________________________________________

Type of film (if any) _________________________________________________

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For contest coordinators and judges only:

Entry Number _____________________________________________________

Place Award (if applicable) ______________________________________________