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2010 CERTIFICATION AND ENTRY FORM (Must be mailed with pictures and drawings) College or University: ________________________________________________________ Student Chapter(s) Name: ________________________________________________________ Student Chapter Address(Must be accurate and complete - awards to be mailed here!) : ________________________________________________________ ________________________________________________________ Phone __________ Fax _________ E-Mail _____________________ Faculty Advisor: ________________________________________________________ Person in Charge of Project (Contact): ________________________________________________________ Faculty Advisor Certification : ________________________________________________________ DEADLINE FOR SUBMITTAL is April 2, 2010 MAIL TO :Southwest MS RC&D, Inc. 1395 Johnny Johnson Drive, Suite E Brookhaven, MS 39601 All materials received by the sponsoring organization will be the property of
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Report errors to: Keith Mazer.