Youth Poetry Application Form

Contact Information

Day-Month-Year

If applicant is under the age of 18, please provide name of parent or guardian

If applicant is under the age of 18, please provide email of parent or guardian

If applicant is under the age of 18, please provide phone number of parent or guardian

Submission Elements

Applicants must include in their submission the following:

  • One (or more) poem(s) inspired by a favourite book
  • The book inspiring your poem must be identified
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Collection and use of your personal information

Information collected on this form is done so under the general authority of the Community Charter and Freedom of Information and Protection of Privacy Act (FOIPPA), and is protected in accordance with FOIPPA. Questions about the collection of your personal information may be referred to the Legislative Services Department at 250-755-4405, or via email at foi@nanaimo.ca. Please also see our Privacy Policy.

Intellectual Property

Last updated: March 11, 2024

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Collection and use of your personal information

Information collected on this form is done so under the general authority of the Community Charter and Freedom of Information and Protection of Privacy Act (FOIPPA), and is protected in accordance with FOIPPA. Questions about the collection of your personal information may be referred to the Legislative Services Department at 250-755-4405, or via email at foi@nanaimo.ca. Please also see our Privacy Policy.