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Official Entry Form and Declaration of Originality


Note: Student entrants who are under age 18 as of March 19, 2010 must have forms signed by parents/guardians. The video submission can be uploaded via YouTube or to Memorial's web server. The entry form has to be mailed or faxed (709-737-8699) separately. Any questions or enquiries may be e-mailed to rant@mun.ca.

Entrant's Name:
Full Mailing Address:
 
Phone number with area code:
E-Mail Address:
Birthdate:
Name/address of High School where currently enrolled:
Expected date of graduation from H.S.:
Title of Entry:
Video Format Upload File YouTube URL
Over the age of 18?: Yes No
Note: Student entrants who are under age 18 at March 16, 2007 must have forms signed by parents/guardians. The project can be e-mailed (rant@mun.ca) or uploaded, and the entry form mailed (mailing address) or faxed (709 737-8699) separately.
To be checked by the student competitor.
I, the undersigned, hereby certify that my entry in the Rant like Rick contest is my original work, and no part of it is the property of another. I also accept that my work may be used for promotional purposes by Memorial University of Newfoundland, and that my name may be attached to this promotion. I have read and understood the rules and regulations in regards to this contest. (Questions about the collection and use of this information may be directed to Jill Hunt, Communications Coordinator, (709) 737-8613, jmhunt@mun.ca.
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Please contact us at rant@mun.ca.

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Last Updated: January 13th, 2008