For a printable version of the student registration and entry submission form, please click here. Writing Competition Registration and Submission Form Step 1 of 9 - Overview 11% Overview The University of Mississippi Writing Competition is an annual mail-in writing competition for 7th-12th grade students. The competition consists of multiple writing categories, centered around a theme. All entries must be submitted using this online registration form and upload portal and adhere to the rules and guidelines of the competition. Competition details, rules and guidelines are available on our UM Writing Competition webpage. Student Information Please enter the participating student's information in the following fields.Student Name(Required)Please enter the name of the participating student. First Middle Last Preferred NamePlease enter the name the student is known by. Pronouns he, him, his she, her, hers they, them, theirs ze, zir, zirs per, per, pers Name Only Other Other Pronouns UsedPlease list the pronouns you want people to use to refer to you. Date of Birth(Required) Month Day Year Gender(Required) Female Male I'd prefer not to answer Other Race(Required) American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White I'd prefer not to answer Other Ethnicity(Required) Hispanic or Latino or Spanish Origin Not Hispanic or Latino or Spanish Origin I'd prefer not to answer Student Address and Contact Information Please enter the participating student's address and contact information in the following fields.Mailing Address(Required) 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 Student Email(Required)Please use a non-school email. Some school servers restrict email messages from external sources. Enter Email Confirm Email Student Phone Academic and School Information Please enter the participating student's academic and school information in the following fields.Current Grade Level(Required)123456789101112Anticipated 12th Grade Graduation Year(Required)202120222023202420252026202720282029203020312032203320342035What type of school does this student attend?(Required) Public Private Homeschool School Name(Required)Please enter the name of the participating student's school. If homeschooled, enter "Homeschool" or the name of the homeschool association. School District School City School County/Parish School StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Parent and Guardian Information Please enter the participating student's parent(s) and/or guardian(s) information in the following fields.Parent/Guardian 1 InformationParent/Guardian 1 Name(Required) Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Last Parent/Guardian 1 Email(Required) Parent/Guardian 1 Phone(Required)What is the parent/guardian 1's relationship to the student?(Required) Is this parent/guardian 1 an emergency contact?(Required) No Yes Does parent/guardian 1 work at the University of Mississippi?(Required) No Yes Parent/Guardian 2 InformationParent/Guardian 2 Name Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Last Parent/Guardian 2 Email Parent/Guardian 2 PhoneWhat is the parent/guardian 2's relationship to the student? Is this parent/guardian 2 an emergency contact? No Yes Does parent/guardian 2 work at the University of Mississippi? No Yes Household Information Please enter the participating student's information in the following fields.Did a parent or guardian graduate from a four-year college/university?(Required) No Yes How many family members live in your household, including yourself?(Required)12345678 or moreI'd prefer not to answerWhat is your household's combined income level?(Required)$0 to $10,000$10,001 to $20,000$20,001 to $30,000$30,001 to $40,000$40,001 to $50,000$50,001 to $60,000$60,001 to $70,000$70,001 to $80,000$80,001 to $90,000$90,001 to $100,000$100,001 or moreI'd prefer not to answerDoes this student have siblings?(Required) No Yes If "yes," please list their names and ages. (Ex: John Smith 10) Does this student have any relatives who have attended the University of Mississippi?(Required) Aunt/Uncle/Cousin Grandparent Parent/Guardian Sibling None Previous Participation Information Has this student participated in other programs at the University of Mississippi? No Yes If yes, which programs and years has the student participated? How did you hear about our program? Blog or publication Email Facebook Instagram Recommended by a friend, family, or colleague School Search engine (Google, Yahoo, etc.) Traditional Mail Twitter UM Faculty/Staff Website Other If "Other," how else did you hear about our program? Writing Submission Information Please enter information in the following fields regarding the participating student's teacher information and writing submission(s).Teacher Name Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Last Teacher Email How many entries are you submitting?(Required)123Writing Entry #1Title #1(Required) Category #1(Required) Essay Poem Short Story Entry Upload #1(Required)Please use an approved file format (.doc, .docx, .pdf) when uploading an entry.Max. file size: 64 MB.Writing Entry #2Title #2 Category #2 Essay Poem Short Story Entry Upload #2Please use an approved file format (.doc, .docx, .pdf) when uploading an entry.Max. file size: 64 MB.Writing Entry #3Title #3 Category #3 Essay Poem Short Story Entry Upload #3Please use an approved file format (.doc, .docx, .pdf) when uploading an entry.Max. file size: 64 MB. CertificationOriginal Author Certification(Required) I certify that I, the participating student, am the original author of each work submitted in this registration. I acknowledge and understand that if my work is deemed in violation of plagiarism or copyright that my work will be immediately disqualified from the competition.Original Author Signature(Required) Use of Original Work Authorization (if under 18 years old, please have a parent or guardian complete and certify this part)(Required)Do you authorize UM to use and/or publish this original work (e.g. written material, art, photographs, other created content)? I understand that UM may use this content at its sole discretion for its educational purposes in all forms of media, including social media. I understand that I have no edit, inspection, or approval rights. I release, hold harmless, and covenant not to sue UM for any claims that may arise out of the use of my name, original work, image, voice, or likeness including but not limited to, any claims for defamation, invasion of privacy, or copyright infringement. I AUTHORIZE UM to use my student's original work for publication I DO NOT AUTHORIZE UM to use my student's original work for publication Photography Authorization (if under 18 years old, please have a parent or guardian complete and certify this part)(Required)Do you authorize UM to capture this participant's name, image, voice, or likeness in still photograph and audio or video recording? I understand that UM may use this content at its sole discretion for its educational purposes in all forms of media, including social media. I understand that I have no edit, inspection, or approval rights. I release, hold harmless, and covenant not to sue UM for any claims that may arise out of the use of my name, image, voice, or likeness including but not limited to, any claims for defamation, invasion of privacy, or copyright infringement. I AUTHORIZE UM to capture my student's name, image, voice, or likeness in still photograph and audio or video recording. I DO NOT AUTHORIZE UM to capture my student's name, image, voice, or likeness in still photograph and audio or video recording. Parent / Legal Guardian Certification(Required)I certify that I am the listed original creator's parent or legal guardian.
