Midwest Life Calendar Competition Use this form to register your interest in an opportunity to submit images reflecting 'Midwest Life' that will be incorporated into a 2022 calendar and displayed on the mall banners Save Your ProgressYou have the ability to save this form and complete it at a later date. An email will be generated and sent to the specified address. Email Address: * Required Field * Must be a valid email. Password: * Required Field There is no way to resend or recover your password, please write it down. Note: Incomplete forms are kept for a period of 2 day(s), after this time the system will automatically delete your response. Photographer Details Photographer/Group Name:*This field is required. * Required Field. Primary Contact Name:*This field is required. * Required Field. ABN (if applicable): Phone (mobile preferred):*This field is required. * Required Field. Residential/Business Address:*This field is required. * Required Field. Email Address:*This field is required. * Required Field.* Please enter a valid e-mail address. Are you a resident of the Midwest Region?*This field is required. YesNo Age Group:*This field is required. Under 18*18 years and over *If under 18: I provide consent for my child to apply for this opportunity. Parent Name: Image details Name of Artwork 1:*This field is required. * Required Field. Artwork 1 Description:*This field is required. * Required Field. Upload Artwork 1*This field is required. Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Name of Artwork 2: (optional) Artwork 2 Description: (optional) Upload Artwork 2 (optional) Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Name of Artwork 3: (optional) Artwork 3 Description: (optional) Upload Artwork 3 (optional) Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Terms and Conditions Terms and Conditions Click here to view the Terms and Conditions Have you read and accepted the Terms and Conditions*This field is required. Yes Type the code from the image: The code you entered is not valid. Get Audio CodeType the code from the image Save & Exit