2018 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 6, 2018

MAIL TO :
Bennie Hutchins
328 Covington Cove
Madison MS 39110

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

©2017 Mississippi Association of Resource Conservation and Development Councils.
Report errors to: Keith Mazer.