Tidepools Cover Sheet

Please complete one cover sheet for each entry you submit. DO NOT put your name on the entry itself.

*Denotes required field

First Name: *

Last Name: *

Address: *

City, State, Zip: *

Home Phone: *

Work or Cell Phone: *

Email: *

SURF ID or MCC user name: *

Title of your entry: *

Category (select one): *

For poetry and text, cut and paste your document in this space. For artwork, please submit this cover sheet and also send an e-mail with your .jpg attached to tidepools@miracosta.edu:

Tidepools welcomes submissions from MiraCosta College students, staff, and faculty.
For our records, please select one:
*


In order to help us prevent SPAM, please enter the number before submitting the form.