2011 PHOTOGRAPHY CONTEST ENTRY FORM


___ Youth (under 16) ____ Adult (16 and older)                                                                       

NAME ________________________________________________________________

ADDRESS  ____________________________________________________________

CITY ____________________________________________ STATE ______________

PHONE(__________)____________________________________________________

E-MAIL________________________________________________________________

    ______ Category Wildlife        ______ Category Scenery, Plants, Fungi 

    ______ Digital                     ______ Film

   
Photo Title / Subject ____________________________________________________

Photo Location _________________________________________________________

I understand and agree that Friends of Noxubee Refuge may reproduce any entry for display, website or
publication as needed. I have read the photo contest rules and agree to all conditions contained therein.

Signed: _________________________________________ Date: __________________

Each entry must be accompanied by this form. Entries must be received by 4:00 p.m. on September 15, 2011, at the Noxubee National Wildlife Refuge Office/Visitor Center (located on the south shore of Bluff Lake).  Entries may be turned in at the Visitor Center or
mailed to:  Friends of Noxubee Refuge, 2970 Bluff Lake Road, Brooksville, MS 39739.
No identifying information is to be visible on any surface of the photograph.  For questions, call Andrea Dunstan at (662) 323-5548.