Essay Contest Entry Form

Submit this form when you have completed the program.

Information must be completed & returned
by March 31, 2012.

This is my entry.
(You may enter up to 10 times.)

First Name:

Last Name:

Address:

City:

State:

Zip:

Phone:

( )

School:

Grade:

Name of parent or guardian who can verify
that you completed the program.

All personal information submitted will be held confidential and not used for any purpose other than the requirements of the Reading is an Investment program (mailing information to complete the reading program and entrance into the college savings account drawings).