Ruby Slippers Community Art and Poetry Submission Form English Español Thank you for participating in the 2021 Ruby Slippers “How Do You Know You are Home?” Community Art and Poetry Project! Submitted artwork will be showcased during our Ruby Slippers Gala on Saturday, February 27th as well as throughout the Hope Solutions' Service Sites and Offices. We're thrilled to share your beautiful work. Please take a moment to complete the survey and upload your photos or file of your meaningful art, poetry, or your quote. OK Question Title * 1. Artist Name OK Question Title * 2. Contact Information (Please use your parent or guardians information if under 18) Address Apt, Suite, Unit (if applicable) City State ZIP Code Email Address Mobile/Cell Number OK Question Title * 3. My submission type is: Artwork Poem Personal Quote Comments: OK Question Title * 4. Title of Artwork/Poem (if applicable) OK Question Title * 5. Upload your masterpiece! If you're uploading a photo of your artwork, please ensure you take a picture of the art with good lighting and frame the artwork. File size limit is 16MB JPEGs preferred. PDF, DOC, DOCX, PNG, JPG, JPEG file types only. Choose File Choose File No file chosen Remove File If you're uploading a photo of your artwork, please ensure you take a picture of the art with good lighting and frame the artwork. File size limit is 16MB JPEGs preferred. OK Question Title * 6. We'd love a photo of the artist as well! (Optional) File size limit is 16MB JPEGs preferred. PNG, JPG, JPEG file types only. Choose File Choose File No file chosen Remove File File size limit is 16MB JPEGs preferred. OK Question Title * 7. Photo Release Agreement: By clicking here I hereby authorize HOPE SOLUTIONS to use photographs/videos/audiotape of myself and/or child/ren named below in advertising, websites, brochures, newsletters, reports, grants, and other promotional items and purposes. I further waive any claims against HOPE SOLUTIONS and/or its employees and/or agents based upon or related to its use or publication of my likeness, voice and/or picture. This release allows HOPE SOLUTIONS to use, without compensation or prior notice, images described above. However, as a courtesy, a copy of the publication will be provided to you, when possible. Yes, I Authorize Consent No, I Do Not Authorize Consent OK SUBMIT