Student Design Competition Registration

Please complete the form to enter

*Indicates required fields

*First Name:
 MI:
 *Last Name:
*Institution Name:
*Instructor Name:
*Email:
*Address 1:
Address 2 (optional):
*City, *State, *Zip:
     
*Area Code & *Phone:
 
*Retail Value:
*Select category/categories:
Category check one or more
 Rings
 Pendants/Enhancers/Brooches
 Earrings
 Bracelets
 Other
*Description of entry:
Newspaper name:
Newspaper address 1:
Address 2 (optional):
City, State, Zip:
     
  By checking this box, I agree to abide by the rules of the WJA Design Competition and the final decision of the judges. By submitting an entry or entries for consideration I agree to hold the WI Jewelers Assn., its officers and directors, its staff and employees and its members harmless from any and all claims, litigation or other legal proceeding. I understand that WJA will be responsible only for the replacement cost of materials and labor payable in the event of loss or theft of any entry while in the possession of WJA. I also understand that WJA agrees to take all necessary precautions to assure the safety and security of jewelry submitted. WJA recommends that I so insure my entry or entries. WJA suggests entrants retain a photocopy of the entry form for their files. WJA reserves the right to photograph all jewelry submitted for the Design Competition.