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Young Reporter's Club

Epilepsy Foundation » Newsroom » Young Reporter's Club » Young Reporters Club Entry Form

Young Reporter's Club Entry Form

Please submit your entry for the 2005-2006 Young Reporter's Club below, or send an email containing the information requested below to editor@efa.org, with your article attached in Microsoft Word or Adobe Acrobat (PDF) format.

Personal Information

*First Name:

*Last Name:

*Address:

*City/Province:

*State:

*Zip Code:

*Email:

Phone:

School Information

*Name of High School:

*Grade:

Name of Journalism Advisor:

*Headline of Entry:

*Has this piece been published?: No Yes

Where published?:

Date of Publication:

Upload Your Entry

*Upload Your Entry

This form only accepts MS Word (.doc) or Adobe Acrobat (.PDF) files.