on backGIVA Creative Arts CompetitionEntry FormPlease TYPE or PRINT LEGIBLYVeteran Contact InformationVeteran Name Last 4 of SSN Phone NumberAddressCityStateZipNumber of Entries you wish to submitOnly ID: 863332
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1 Continued on back GIVA Creative Arts
Continued on back GIVA Creative Arts Competition Entry Form Please TYPE or PRINT LEGIBLY V eteran Contact Information Veteran Name: Last 4 of SSN: Phone Number: Address: City: State: Zip: Number of Entries you wish to submit (Only 1 entry per Sub - category allowed, not to exceed 3 total submissions) Please check mark below which sub - category you wish to enter: Applied Art Categories Kit Categories Creative Writing Categories Acrylic Painting Assemblage Beadwork Carving Collage Colored Drawing Crocheting Fiber Arts (original design) Glasswork Glazed Ceramics Group Art Jewelry (no beads) Knitting Knotting Leather Carving/Tooling Leather Stamping Metalwork Mixed Media Monochromatic Drawing Mosaic Needlework (original Design) Oil Painting Pastels Photography (Black & White) Ph
2 otography (Color) Pottery 
otography (Color) Pottery Printmaking Pyrography Scroll Saw / Fretwork Sculpture Watercolor Woodworking Craft Coloring Kits Fabric Art Figurine Painting Latch Hook Leather Mosaic Needlework Paint by Number Sand Art String Art Suncatcher Transfer / Engraving Art Wood Building Essay Monologue / Duologue Personal Experience Short Poetry Short Story Briefly describe the art work(s) you wish to submit: Please return application either in person or via email to: Alicia Wicht, Whole Health – Building 6 2201 N. Broadwell Ave Grand Island, NE 68803 Phone: 308.395.3404 Email: alicia.wicht@va.gov All applications are due by January 15, 2020