School of Languages, Cultures, and RaceAFSC form wider WSU Community AFSC form wider WSU Community Art for Social Change Submission Form Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Standing* Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade Freshman Sophomore Junior Senior Community College Community Member Submission Category* Remembering MLK Social Justice in Action Community Outreach Submission Title* Submission Type* Poster Painting Drawing Performance Sculpture or other 3-D piece Digital media Original music composition Short film Creative writing Poetry Graphic Novel Mixed media/multi-media art Brief statement describing the intent of the submission*How are you submitting your creative works?* By mail In person Upload a digital file Do you want your submission returned to you?* Yes No *Students are responsible for picking up their submissions after the event.Release of Liability* By checking this box, I understand that Washington State University and the School of Langauges, Cultures, and Race is not responsible for reimbursement or replacement of lost, damaged, or stolen artwork. I also agree that Washington State University will not indemnify or insure my artwork for damages to the work itself or for any loss that may result from the installation of the artwork. Statement of Originality* By checking this box and submitting this form, I agree to the Statment of Originality above. I hereby declare that this submission is my own original work and to the best of my knowledge it contains no materials previously published or written by another artists, person, published source, or reference not attributable to the artist. I hereby attest to my submission is compliant with the submission criteria and guidelines. *I hereby give the WSU School of Languages, Cultures, and Race permission and the right to reproduce and use my artwork in future Art for Social Change Competition promotional material.File Upload* Drop files here or Select files Max. file size: 146 MB. EmailThis field is for validation purposes and should be left unchanged. Δ