Ulayaw [Application Form]

Page 1

NAME: __________________, __________________________________ ______ (Last Name, Given Name M.I.) PSEUDONYM: ______________________________ (to be used on all entries)  Currently Enrolled Course, Year & Section: _____________________________  Alumni Course & Year Graduated: ___________  Former COC Student COC Department: _______________________ AGE: _______

CONTACT #________________________

Current Course: ___________________________ E-MAIL ADDRESS: _____________________________

ENTRY/ ENTRIES  Short Story  Maikling Kwento  Poem  Tula  Essay  Sanaysay  Traditional Art  Digital Art  Photography

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pon my word of honor, I do solemnly swear that I am a genuine COCian whose submitted works are all original and unpublished. Any form of copyright infringement to be found in my works will not hold The Communicator, or any member of its Editorial Board for that matter, liable in any way.

________________________________ Signature of Entrant (over printed name)


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