CERTIFICATION AND ENTRY FORM

(Must be mailed with pictures and drawings)

 

 

College or University:

________________________________________________________

Student Chapter(s) Name:

________________________________________________________

Student Chapter Address (Must be accurate and complete - awards to be mailed here!) :

________________________________________________________

________________________________________________________

Phone __________ Fax _________ E-Mail _____________________

Faculty Advisor:

________________________________________________________

Person in Charge of Project (Contact):

________________________________________________________

Faculty Advisor Certification :

________________________________________________________
(signature)                                                                                     (Date)

DEADLINE FOR SUBMITTAL is April 4, 2008

MAIL TO :
Southwest MS RC&D, Inc.
1395 Johnny Johnson Drive, Suite E
Brookhaven, MS 39601

All materials received by the sponsoring organization will be the property of the organization!
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