2010 ANNUAL

FRIENDS OF BLACK BAYOU, INC.,

PHOTO CONTEST

ENTRY FORM

Each entry must be accompanied by this completed form.

Entries may be mailed [Mark DO NOT BEND!] to Friends of Black Bayou, Inc., Post Office Box 9241, Monroe, Louisiana 71211; or delivered to Friends of Black Bayou, Inc., Black Bayou Lake National Wildlife Refuge, 480 Richland Place, Monroe, Louisiana 71281.

Do not mail entries to the Refuge address.

Whether mailed or delivered, entries must be received by noon, October 1, 2010, to be

eligible for the contest.

No identifying information is to be placed on the face of any photograph or mat.

Entrant: Adult ____Youth (17 or under):____ Date Submitted:_____________________

Category : Scenic____ Wildlife____ Birds____ Plants____ People on Refuges____ Macro/Micro____

Name:_______________________________Telephone:__________________________

Address:________________________________________________________________

E-Mail:___________________________ Title of Entry:__________________________

Refuge Where Taken:______________________________________________________

I have read the Contest Rules, and understand and agree to all provisions and requirements set forth within them. I certify I personally took this photograph.

SIGN: ______________________________

PRINT: _____________________________

WRITE ADDITIONAL INFORMATION ABOUT YOUR PICTURE ON THE BACK