Age: __________________________________ Bithdate: _____________________________
(Phone numbers and addresses will NOT appear in calendar, they will be used for contact purposes only)
Phone: __________________________________ Address: _____________________________
Tribe: __________________________________ _____________________________
Please tell us something about yourself, such as: Special talents, community involvement, aspirations, achievements, or what changes you would like to see for Native people.
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Please include three (3) clear, undamaged photos of yourself. All photos and written submissions become the property of "Rez Rootz Clothing". Photos will not be returned, as winning entries may be used in the calendars. Submissions must be received by November 30th, 2003. By signing this entry, you agree to the above stated terms. If you are not yet 18 years old, your parent/guardian MUST sign this form, allowing you to appear in the "Rez Rootz" Calendar.
_________________________________________________ ______________________ Signature Date
_________________________________________________ ______________________ Parent/Guardian's Signature (only if under 18) Date
ALL ENTRIES MUST BE SIGNED
PLEASE CONTACT US AT [email protected] FOR INFORMATION ON MAILING YOUR ENTRY FORM.