Astronomy Competition Entry Form

Deadline for entry: 11:59pm on Friday 15th November 2019

Firstname

Surname

If you are entering on behalf of a child, please include their name here

Child’s first name

Child’s surname

E-mail

Phone number

Year of birth

Type of contribution

If other, please give details

Please either send your contribution to Thomas Millichamp Department of Physics University of Warwick Gibbet Hill Road Coventry CV4 7AL or upload your contribution using the box below.

Upload your contribution

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Please tick this box to state you agree with the Terms & Conditions of the competition

The University of Warwick would like to publish your or your child’s entry which you/they submitted as part of the “Astronomy meets the Arts Competition”. You can choose whether you would like your name or that of the child [as long as you have parental responsibility for them] to appear beside your/the child’s entry. In order to do so the University of Warwick will need to obtain consent directly from you (if you are over 16 years of age) or from the individual who has parental responsibility (where a child is under 16). You can withdraw your consent to your name or that of the child appearing on the University of Warwick website at any time by emailing physicsadmin@warwick.ac.uk.

I give my consent for my first name / or that of the child mentioned to be displayed next to the entry

I give my consent for the entry submitted here to be published on the University of Warwick website. I understand that anyone with access to the internet can access this webpage.

I am aged 16 or over

I am a parent completing this form on behalf of my child who is under 16 [who I have parental responsibility for]

Please email Thomas.Millichamp@warwick.ac.uk in case of any queries

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