Old Slater Mill Association 67 Roosevelt Avenue PO Box 696 Pawtucket, RI 02862-0696 401.725.8638 / info@slatermill.org LIGHT US UP with Your Ideas PARTICIPANT APPLICATION Date: __________________ Name(s) ________________________________________________ DOB: _______/_______/_________ Home address_________________________________________________________________________ Phone_____________________________ Email _____________________________________________ School _____________________________________________Entering grade__________ in September. Description of Submission Title of Work ____________________________________________Date completed___________________ Medium ___________________________________________Size/length*___________________________ Artist’s Statement (use back of page if needed) _______________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ I / We understand the following contest rules: Yo / Nosotros comprendemos las siguientes reglas para concursar: 1) Deadline for entry is 5:00 p.m. on Friday, July 15, 2016 La fecha limite para participar es Viernes, 15 de Julio, 2016 a las 5:00 p.m. 2) Contest is open to Pawtucket and Central Falls residents ages 14 through 18 only. El concurso es únicamente para residentes de Pawtucket y Central Falls entre las edades de 14 a 18 años. *3) Submissions must conform to the following specifications: Video – maximum 2 minutes in length; written work – maximum 1000 words; visual art – maximum 2 MB (no original works please) Las obras deben reunir las siguientes condiciones: Video- máximo dos minutos de duración; trabajo escrito- máximo 1,000 palabras; arte visual – maximo 2 MB (por favor no obras originales) 4) Five entries will be selected to win prizes of $150, $100, $75, $50, or $25. Prize money will be paid in the form of a check made payable to each winner. Cinco participantes serán los seleccionados para ganar premios de $150, $100, $75, $50 o $25. El premio sera entregado con cheque a nombre de cada ganador. 5) Images, words or concepts from the winning entries may be used and displayed as part of the public art project and its promotion. Old Slater Mill Association does not retain copyright. Artists will be credited for work used in any promotional materials Imagines, palabras o conceptos de las obras ganadoras se pueden utilizar para la promoción y duración del proyecto de arte público. Slater no reserva los derechos de autor. Los artistas serán acreditados en todos los materiales promocionales en los cuales su trabajo sea utilizado. 6) Employees of the Old Slater Mill Association and their families are not eligible to enter Los empleados y familiares de Old Slater Mill Association no son elegibles para participar en este concurso. __________________________________________________________________________________ Signature of Applicant Print Name Date If applicant is under the age of 18, a parent or legal guardian must give their consent by signing below. Si el participante es menor de 18 años, su padre o su representante legal debe autorizar la participación del candidato en este concurso firmando a continuación: __________________________________________________________________________________ Signature of Parent or Guardian Print Name Date