Exit Copy of 100 AA Children's Book Authors App. Ages 12& Under Question Title * 1. What is your child's first and last name? Question Title * 2. What grade is your child in? Question Title * 3. What City and State does your child reside in? Question Title * 4. How old is your child? Question Title * 5. How often does your child read? 20-30 mins a day Reading as required by school Once or twice a week Almost never I don't know Question Title * 6. If my child is selected to participate in this writing opportunity, I will ensure that he/she watches the provided videos and speak with his/ her Advisor? Yes No Question Title * 7. Does your child have any special needs that may act as a barrier to completing this writing assignment? If so, what are they? Question Title * 8. Please select one of the following writing forms that you would be interested in writing in for this book project. After selecting your writing form please email a one page double spaced writing sample focusing on the topic, social injustice. You can write about how it makes you feel, a possible solution to social injustice, or you can be creative. Once you write your 250 - 500-words story email it to 100aaca@gmail.com by Friday, October 2nd, 2020 by 5 pm. Essay Short Story Poetry Question Title * 9. What is your child's ethnicity? Question Title * 10. What is your contact information? Name Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Done