Fractios Digital Photography Contest
Entry Form Page 2

Please verify the listed information:

[[firstname]] [[lastname]]
[[streetaddy]]
[[city]], [[state]] [[zip]]
[[email]]
Name of your contest entry: [[photographname]]

The information listed above is correct:

Upload the digital photograph you wish to enter
in the Fractios Digital Photography Contest:

(.jpg, .jpeg, .gif - maximum size 250k):

I affirm I am the original photographer of the image being submitted for the Fractios Digital Photography Contest.