Last NameFirst Name

Your Contact Information

Address

Telephone

Age

Email Address

City Province/Territory Postal Code

Your Contest Submission

Submission Title

Please submit your artist’s statement explaining the work and how it relates to the theme In Flanders Fields (200 words max)

Entry Category

Visual art

Photography

Digital art

Literary art

Mailing Address:Encounters with Canada, 1805 De Gaspé Ave. Ottawa, ON, Canada K1K 0A4

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Please indicate to what extend you agree or disagree with the following statements.

Short survey

Through participation in the In Flanders Fields contest:

1. I gained a better awareness and appreciation of the great sacrifices of Canadian soldiers indefending and liberating Belgium in WWI and WWII.

a. Strongly agreeb. Somewhat agreec. Somewhat disagreed. Strongly disagree

2. I learned more about the contributions and achievements of Canadians, who have served in thecause of peace and freedom.

a. Strongly agreeb. Somewhat agreec. Somewhat disagreed. Strongly disagree

3. I increased my knowledge about John McCrae's poem, "In Flanders Fields," written while he wasserving in Ypres as a surgeon.

a. Strongly agreeb. Somewhat agreec. Somewhat disagreed. Strongly disagree

Thank you for taking the time to complete this survey. Your answers are completely confidential.

I confirm that I am above the age of majority in my province or territory of residence. If I am below the age of majority, I have parental consent to enter the In Flanders Fields contest.

I confirm that my submission is an original work, and no part is plagiarized. I understand that any entry submitted, which uses copyrighted materials (including, but not limited to, images and songs) without the proper permissions for use, will be disqualified.

I have read and understood the In Flanders Fields contest Rules and Regulations.

Mailing Address:Encounters with Canada, 1805 De Gaspé Ave. Ottawa, ON, Canada K1K 0A4