ALLIANCE FOR YOUNG ARTISTS & WRITERS

Grade: 12
REGION: OR001A CERAMICS & GLASS
Oregon Art Region
12/02/2021
13:39:39 ET
2022 SUBMISSION FORM
STUDENT INFORMATION INSTRUCTIONS

Nicohlas Pajela Submit this form to:

564 Paradise St., Woodburn, OR 97071 Please submit your form digitally only. Do not mail to Pacific
Age: 17 Grade: 12 Northwest College of Art at Willamette University. DO NOT
Email: 22npaje5@woodburnsd.org SEND IN ORIGINAL ARTWORK Online payment is available
Parent/Guardian email: jess.pajela@icloud.com through your Scholastic Awards account.

Woodburn Arts & Communications Academy Deadline: 01/06/2022

1785 N FRONT ST
Woodburn, OR 97071 Submission Fee: $7.00
Jefferson Cook (jcook@woodburnsd.org) Additional Details:
Submission form upload is also available through your
Scholastic Awards account.
WORK SOURCES

My own observations, ideas, and imagination

A Tire d Cup of Coffe e

Ceramics & Glass
Barcode: 14169002

NOTE: Registration for this work is incomplete (as of 12/02/2021 13:39:39 ET)
You may still sign and sub mit this form, b ut please rememb er to complete the registration b efore the deadline!

TERMS & CONDITIONS

I affi rm that al l i nformati on entered through the Onl i ne Regi strati on System (ORS) i s true and accurate. I understand the fol l owi ng: the i nformati on I
provi ded may not be changed or corrected after my regi strati on deadl i ne has cl osed; I grant permi ssi on to the Al l i ance and i ts Affi l i ate Partners to
publ i sh, i n al l pri nt and el ectroni c medi a, the student's name, age, grade, school , and educator i nformati on; the Al l i ance and i ts Affi l i ate Partners
may rel ease i nformati on entered through the ORS to col l eges and uni versi ti es i nterested i n recogni zi ng and supporti ng students who have submi tted
to the Schol asti c Awards, as wel l as for consi derati on for addi ti onal schol arshi p and recogni ti on opportuni ti es; works recei vi ng nati onal awards wi l l be
hel d for up to two years. I further agree and acknowl edge that the Al l i ance has the authori ty, i n i ts sol e di screti on, to revoke any awards i ssued by the
Al l i ance i n the event the Al l i ance determi nes that a submi ssi on does not meet the requi rements of the Parti ci pati on Terms or other Al l i ance pol i ci es;
the Al l i ance assumes no responsi bi l i ty for l ost or damaged work; i f any el ement of the submi ssi on requi res ri ghts rel eases, al l ri ghts and permi ssi ons
have been obtai ned, as requi red by l aw.
I have read, ful l y understand, and agree to al l requi rements for parti ci pati ng i n the Schol asti c Art & Wri ti ng Awards as outl i ned above, i n the
gui del i nes, and i n the Parti ci pati on Terms (i ncl udi ng the Copyri ghts Rel ease, Copyri ght & Pl agi ari sm, and Terms of Artwork Return pol i ci es).

Student Signature:
Nicohlas Pajela Date
Parent / Guardian
Signature:
Jess Pajela Date