Gilbert-Chappell Distinguished Poet Series – Student Poet Entry Form
Please complete and staple to your three pages of poetry.
Name ____________________________________________ Age _____ Grade _______
School or Public Library: __________________________________________________________
Street ____________________________ City _______________ _ County Zip _____ ___
School or Public Library Phone: (_____) _____________________
Teacher or Public Library Contact: _________________________
Email: _________________________________
Student Poet’s Home Address: _________________________________________________________
City ___________________________________ Zip Code ___________
Home Email: __________________________
I am entering (check one) [ ] through my school [ ] through my public library
As a Student Poet I agree to:
- Send approximately one dozen pages of poetry to the Distinguished Poet on a schedule to be determined by the Distinguished Poet.
- Respond in writing to suggestions made by the Distinguished Poet.
- Attend at least two face-to-face meetings with the Distinguished Poet.
- Read poetry with the Distinguished Poet and the two other Student Poets at the regional reading.
[ ] I have read, understood and accept the above Gilbert-Chappell Distinguished Poet Series Guidelines.
Student Poet’s signature ______________________________________
A parent’s signature is required if you are under 18 years of age.
Parent’s signature _________ ___________________________________
Mail Your Application and Poetry to the appropriate Gilbert-Chappell Distinguished Poet Series Regional Coordinator:
Eastern Region: Kelly Jones, Regional Coordinator, 166 Willow Street, Tabor City, NC 28463; kellyjonesncps@gmail.com; (910) 770-2623
Central Region: Sherry Siddall, Regional Coordinator, 942 Old Post Rd, Chapel Hill, NC 27517;
sherrysiddall@gmail.com; (919) 423-0033
Western Region: Caleb Beissert, Regional Coordinator, 123 Forest Hill Drive, Asheville, NC 28803; caleb.gcdps@gmail.com; (704) 975-3636
To determine the appropriate region for your North Carolina county, click here.