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2024 Congressional Art Competition Registration
Student Information & Release Form
This information is used for certificates and selecting awards. Incomplete forms will not be accepted.
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* Indicates required question
Email
*
Your email
Student Information
First and Last Name
*
Your answer
Pronouns: If you feel comfortable, please self-identify your pronouns
Your answer
Grade
*
Your answer
Home Street Address
*
Your answer
Home Town/City
*
Your answer
County
*
Choose
Chittenden
Addison
Bennington
Windham
Windsor
Rutland
Washington
Essex
Orange
Orleans
Lamoille
Franklin
Grand Isle
Caledonia
Home Zip Code
*
Your answer
Mailing Address (If Different)
Your answer
Student Phone Number
*
Your answer
Student Email Address
*
Your answer
Parent or Guardian Information
Parent or Guardian Name(s)
*
Your answer
Parent or Guardian Phone (Home)
*
Your answer
Parent or Guardian Phone (Cell or Work)
Your answer
Parent or Guardian Email
*
Your answer
School
School Name
*
Your answer
School Address
*
Your answer
Town
*
Your answer
County
*
Choose
Chittenden
Addison
Bennington
Windham
Windsor
Rutland
Washington
Essex
Orange
Orleans
Lamoille
Franklin
Grand Isle
Caledonia
Art Teacher Name
*
Your answer
Art Teacher Email
*
Your answer
Art Teacher Phone
*
Your answer
Art Competition Entry
Title of Entry
*
Your answer
Medium - Example: Acrylic on canvas, pencil on paper, etc
*
Your answer
Size: Height and Width in Inches - Not including framing or backing
*
Your answer
Description
Please include a detailed description of the artwork, clearly identifying the major elements of the piece.
*
Your answer
Artist Statement
: If you are able, please share what themes, ideas, and/or motivation supported you as you were creating your artwork.
Your answer
Is your artwork investigating one of our Art Competition Themes? If yes, please select which theme below.
Community
Resilience
Both Community and Resilience
I did not choose to investigate one of these themes
Clear selection
We will collect all artwork in early April - Which drop off location will your school be using? This is a preliminary list - as potential additional sites come online, we will communicate that to regionally specific schools.
Brattleboro Museum and Arts Center
Edgar May Recreation Center - Springfield
Community College of Vermont - Rutland
Vermont Arts Council - Montpelier
River Arts - Morrisville
Catamount Arts - St. Johnsbury
Office of Congresswoman Balint - Burlington
Clear selection
Do you give permission for us to post images of your artwork on our website and our social media?
*
Yes
No
If you participate in the Congressional Art Competition Event in May, if you are included in photographs from the day, do you give us permission to post those images on social media and our website?
*
Yes
No
If your artwork is selected as a winner - are you interested in having your artwork displayed at locations throughout the state after the competition and/or in our Congressional offices for the following year?
Yes
No
Other:
Clear selection
Have you emailed your student release and artwork photo through to Morgan Nichols at morgan.nichols@mail.house.gov ?
Yes
No
Other:
Clear selection
A copy of your responses will be emailed to the address you provided.
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