Select the information below and copy to an MS Word document. Print and fill out. 

Miami Dade College 

The Earth Ethics Institute
Photography Challenge 2008

“Visions of Nature in South Florida”
MDC Student Contest Entry Form 
W-9 or W-8 BEN form must be submitted with this entry form

(Print and neatly complete in pen or word processor, then tape to the back of  each photograph submitted
Print out this required W-9 form (US person including a resident alien) or
this W-8BEN form  (certificate of foreign status) and tape to back of each photograph.

Entries are due Wednesday, March 12 at 3 pm
ALL ENTRIES OUTSIDE DIMENSION OF WINDOW MATTED PHOTO MUST BE 16" x 20"

Student name:             ____________________________________________
MDC Student ID #:        ____________________________________________
Main Campus:              ____________________________________________
Student address:          ____________________________________________
                                   ___________________________________________
                                   ____________________________________________

Daytime phone:           ________________________________
Evening phone:           ________________________________        
Email:                       _________________________________

Person and Campus to whom photo was submitted for judging _____________________________________
Title of this image __________________________________________________________________________
Location where image was shot ______________________________________________________________
Why did you choose this image to represent your vision of Nature in South Florida?
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________

I hereby certify that this photograph is entirely my own work. I agree to allow the Miami Dade College, Environmental Ethics Institute to display this photograph electronically or in any exhibition, but I understand the College is not liable for any damage to or loss sustained by the photograph after it is submitted for judging. I understand that I may be interviewed by the judges regarding the process  of creating this image.  Photographs are due 3:00 pm, Wednesday, March 12, 2007

 ______________________________________       __________________

Applicant's signature                                                                          Date

Turn in your entries by Wednesday, March 12 at 3 pm to: 

North Campus
Stephanie Parker -Room 6104 ; Jan Mast -Room 2256-29;
Sandra Schultz -Room 3242-19

Kendall Campus:  
Dick Townsend -Room 6206; Brad Stocker -Room 3212-10;
Eric Lichtman - Room 2202-9; Dominic Brucato -Room 6206-2

Wolfson Campus:
Chris Migliaccio -Room 1540;
Earth Ethics Inst. Office 3506

Medical Center Campus:  
Carol Petrozella (Nursing Department)

InterAmerican Campus:
Carlos Gonzalez - Room 1347; Emily Sendin -Room 1357

Hialeah Campus:
Glenda Phipps - Media Center 

Homestead Campus:
Judy Lever-Duffy -Room B127