Deadline: Friday, December 8, 2017 by 5:00 pm

By submitting this School Final Report Form and selected student poems you are confirming your school’s intent to participate in all official regional, state and national contests and affirming your student’s ability to compete beyond the school level.

For more information visit http://www.arts.virginia.gov/programs_POL.html

contact
Casey Polczynski
804.225.3132
casey.polczynski@vca.virginia.gov.

* 1. School Information

* 2. Region Identification:

Note: For more information about the designated Arts Advisory Regions in Virginia, visit, http://www.arts.virginia.gov/about_advisory.html or refer to the map below:

Note: For more information about the designated Arts Advisory Regions in Virginia, visit, http://www.arts.virginia.gov/about_advisory.html or refer to the map below:

* 3. School Coordinator-Contact Information
Please provide a personal email and phone number.  These will only be used as alternate contact sources. 

* 4. Total Number of POL Participants in Classroom and School Wide Competitions:

* 5. School Wide Poetry Out Loud Champion Information:

* 6. Is the student a U.S. citizen? 

* 7. Selected Poems (2) for POL Regional Competition:

• All poems must be from the official Poetry Out Loud online or printed anthology.
• The selections and order of recitation cannot be changed once submitted.
• Include the location of poem as “OL” for Poetry Out Loud online anthology or "PA, p. xx"
  for the Poetry Out Loud printed anthology with page number included.

* 8. School Wide Poetry Out RUNNER UP Information:

* 9. Is the runner up a U.S. citizen?

* 10. Selected Poems (2) for POL Regional Competition RUNNER UP:

• All poems must be from the official Poetry Out Loud online or printed anthology.
• The selections and order of recitation cannot be changed once submitted.
• Include the location of poem as “OL” for Poetry Out Loud online anthology or "PA, p. xx"
  for the Poetry Out Loud printed anthology with page number included.

* 11. School Wide Poetry Out RUNNER UP #2 (Regions 1 and 2) Information:

* 12. Is the runner up a U.S. citizen?

* 13. Selected Poems (2) for POL Regional Competition RUNNER UP #2:

• All poems must be from the official Poetry Out Loud online or printed anthology.
• The selections and order of recitation cannot be changed once submitted.
• Include the location of poem as “OL” for Poetry Out Loud online anthology or "PA, p. xx"
  for the Poetry Out Loud printed anthology with page number included.

Thank you for submitting your School Final Report Form. If you have any questions, please contact me directly.

Casey Polczynski
Arts in Education Coordinator
Main Street Centre
600 East Main Street, Suite 330
804.225.3132

casey.polczynski@vca.virginia.gov

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