2014 PBS KIDS Writers Contest Entry Form
The PBS KIDS Writers Contest is produced by PBS and coordinated by WNED-TV, Buffalo-Toronto
Type or print legibly
Child’s Name_________________________________________________________________________________Age____________________________
Child’s Mailing Address_________________________________________________________________________________________________________
City/State/Zip_______________________________________________________________ Home Phone (_______)_____________________________
Circle Grade:
Kindergarten
1st Grade
2nd Grade
3rd Grade
Sex: F
M
Title of Story________________________________________________________________________________________________________________
Number of Words ______________
Word count range: Grades K-1 minimum-50, maximum-200
(The word count includes “a,” “an,” & “the.”)
Grades 2-3 minimum-100, maximum-350
Number of Illustrations ____________ (minimum of 5)
Only one entry per child • Only single author stories (no co-authors) • Story must be original work of the child • Original art can include drawings,
collages, 3-D and photos taken by the author • Story may be fact or fiction, prose or poetry • Use only one side of the paper • Number each page on
the back • Text must be printed/written legibly or typed; no pencil or blue ink • Children who can’t write may dictate their story to be printed or
typed • Invented spelling is accepted • Story text may be on pages with illustrations or on separate pages • Non-English text must be translated into
English text on the same page and the translated English text must adhere to the word count • Word count includes "a" "an" "the" but not words on
nonstory pages (e.g. title page) or those that enhance illustrations • Paper size: 8-1/2 by 11 inches, no lined notebook paper.
I acknowledge that I have read the Contest rules & regulations prior to signing this and that I understand the rules and give KLRU permission to submit this
entry electronically. I also understand that this work may appear on a KLRU or PBS Kids website with my child's name either in its entirety or with a first name
and last name initial.
Required:
Parent/Guardian Signature _________________________________________ Email address: _______________________________________________
Printed Name_______________________________________________________________________ Date_____________________________________
If different than the above address:
Mailing Address ______________________________________________________________________________________________________________
City/State/Zip_____________________________________________________________ Phone (_______)_____________________________________
Optional for Promotional Offers to Parent/Guardian named above from PBS KIDS partners (LeapFrog & Highlights for Children)
Yes / No (circle one) PBS KIDS partners may contact me via email up to two times for promotional offers related to the PBS KIDS Writers Contest
Optional for School-Related Entry:
Teacher Signature _________________________________________________ Email address:______________________________________________
Printed Name________________________________________________________________________________________________________________
School Name________________________________________________________________________________________________________________
School Mailing Address________________________________________________________________________________________________________
City/State/Zip ___________________________________________________ School Phone (_______)________________________________________
(postmarked/uploaded)
IF YOU MAIL THE ENTRY:
DEADLINE FOR ENTRY:
April 7, 2014
ADDRESS: KLRU-TV
PBS KIDS GO! Writers Contest
IF YOU SUBMIT
ELECTRONICALLY:
P.O. Box 7158
Email the story, with this document included, as a JPG
Austin, TX 78713
or PDF attachment to
PBS KIDS Writers Contest Entry Form, 2014