YOUTHS AGAINST ALCOHOL USE ESSAY C0NTEST
APPLICATION FORM

NAME:______________________________________________________________________________


ADDRESS:__________________________________________________________ ZIP CODE:___________


GRADE:___________________________________________________________________________


LOCAL CHURCH ___________________________ ________________________________


ADDRESS:______________________________________________________________________

_________________________________________________________ ZIP CODE:________________


PASTOR:__________________________________________________________________________


CONFERENCE:______________________________________________________________________

RELEASE FORM FOR PUBLICATION

I AGREE THAT MY SUBMISSION BECOMES THE PROPERTY OF AND MAY BE USED FOR
PUBLICATI0N BY THE UNITED METHODIST REPORTER AND/OR THE INDEPENDENT COMMITTEE ON ALCOHOL AND DRUGS FOR UNITED METHODISTS.


__________________________________________________________________, ________, 20_____ SIGNATURE OF APPLICANT DATE



________________________________________________________________, __________, 20____
SIGNATURE OF PARENT DATE



MAIL THIS APPLICATION TO: ESSAY CONTEST, INDEPENDENT COMMITTEE ON ALCOHOL AND DRUGS FOR UNITED METHODISTS, POST OFFICE BOX 532, RICHARDSON, TEXAS 75083-0532