NYS "Kids Safe Online" Poster Contest - Electronic Submission Form

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* 1. Student's First Name

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* 2. Student's Last Name

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* 3. Grade

Kindergarten

1st

2nd

3rd

4th

5th

6th

7th

8th

9th

10th

11th

12th

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* 4. Special Education Entry?

Yes

No

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* 5. Teacher's Name

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* 6. Teacher's Email

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* 7. School Name

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* 8. School District

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* 9. School Address

Address *

Address 2

City/Town *

State/Province

ZIP/Postal Code *

Phone Number *

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* 10. Poster Upload - labeled as first name last name grade (ie. Jessica Smith K)

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

If you have any questions please contact Jessica Smith (518) 242-5020 Jessica.smith2@its.ny.gov