Smart Alex 2019 Entry Form ENTRY FORM You must complete all fields. First Name: Last Name: Gender: Female Male Gender diverse Email: Name of School: (If home-schooled, please give your parent or guardian’s name) School phone number: (If home-schooled, please give your parent or guardian’s contact number) Alexander Turnbull Library reference number of the item you’re responding to: Which category are you entering? Y9–10 Y11–13 I have read and agree with the terms and conditions. (read them here) I confirm that this is my original work. I have included the Alexander Turnbull Library reference number of the item I’m responding to on this form AND on my entry, attached. Attach your creative work here. Acceptable file types: doc,docx,pdf,txt,jpg.Maximum file size: 5mb. Email your completed entry to SmartAlex100@dia.govt.nz by 5 pm on Sunday 21 July 2019.