2023/2024 National Student Poetry Contest Entry Form (for K-12 students in Canada)

Privacy Policy: Your privacy is important to us. The information provided here will be used solely for the purpose of this contest (i.e. to notify participants regarding contest results and the ensuing publication). No information will be sold or distributed.

The way you type your Preferred and Legal Last Name in this form is how it will appear on the certificate of achievement we mail if your entry is selected for publication. Please input carefully, using proper capitalization.

Legal First Name*

Preferred First Name*

Middle Name or Initial

Legal Last Name*

Grade (K-12)*

Postal Mailing Address (must be in Canada)*

ex: 14510 Mallard Rd or 21-20841 101 St

Unit number (if not included above) or PO Box (if you have one)

CityProvince

Postal Code

Parent/Guardian's Full Name*

Parent/Guardian's Email*

Please note school emails may not allow us to reply or send you an attachment (such as a proof sheet if your work is accepted).

Additional Email (optional)

Would you like to join our email mailing list to be notified of final prize winners and future contests?*

Yes, email me updates a few times a year (select this if you have already subscribed and would like to remain; we won't send duplicates).No, I will check your website myself for updates and to view final prize winners.

Phone Number*

Phone Number

School Name*

Please put Home School if homeschooled.

Before you press submit . . . if you used the AUTOFILL feature of your browser, please go back up and check all fields as it may have replaced information (ex: your parent's name has become your preferred name).

Teacher's First and Last Name*

If you are submitting on your own, we still require a teacher contact. This can be any teacher at your school who knows you, including the principal, your homeroom teacher, or a librarian. If homeschooled, put your parent/guardian's name. Please check with any contact before submitting and let them know to expect mail with your results by mid February 2023.

School Mailing Address (for Canada Post) - if homeschooled, use home address*

School Street Address

School Unit Number or PO Box

School CitySchool Province

School Postal Code

About the Author*

Number of Lines (32 max.)*

Your entry will be disqualified at any point in the contest if discovered to be over the 32-line maximum.

Title of Entry*

Entry (copy and paste poem)*

Please use a 10 to 12-pt plain black font to make it easy to read . Line and stanza breaks should be hard returns (Return key only) rather than soft returns (Shift + Return keys) as displayed on an 8.5 x 11" sheet of paper with normal margins. Do not worry about lines breaking differently in this form (line breaks will vary depending on your screen size). As long as you have the correct hard returns, the formatting should appear correct on our end.

By submitting this entry, I confirm that all phrases, lines, and characters are original and of my own creation (for example, I have not used Spider-Man, Pokémon, celebrities, etc., used a writing prompt where I have copied line(s) or phrases found in a book or online).

If a phrase is not my own, I have properly cited it using quotation marks and noted the source (i.e. author and title of work, including books, videos, games, media, TV, movies, etc.) in a footnote.

If I have used the names of people I know, I have received their express written permission.

If my poem was inspired by another poem, story, song, video game, YouTube video, movie, etc., I have provided the source in the "Additional Comments" section below or as an "Inspired by" line at the top of the poem.

This work is not posted anywhere online, and I will not share it online until after June 2024 if it is accepted for publication.

I have not submitted this work elsewhere recently and do not plan to submit it elsewhere in the near future (no simultaneous submissions).

I confirm my parent/guardian and I have read and agree to the above declaration.*

Yes

Additional Comments to the Judges (special needs, ESL, citation note, etc.)