Online Form - Historic Photo Competition

Full Name *

Address

Email *

Phone

Are you a Mundaring & Hills Society staff employee or executive member or the immediate family member of a Mundaring & Hills Society staff employee or executive member? *

YesNo

Are you a Shire of Mundaring employee or councillor or the immediate family member of a Shire of Mundaring employee or councillor? *

YesNo

Upload Photo (between 1MB and 10MB) *

Maximum size of ALL attachments is 976.56 MB

Name of Photographer (if known)

Year Photograph taken (or decade if unknown)

If the photograph was taken after 1 January 1955, do you have permission from the copyright owner? *

YesNoN/A

Please provide a short description (50 words max) of your photograph including the people, places, events depicted and their relationship to the Shire of Mundaring. *

Have you obtained permission from all the individuals pictured? *

YesNoN/A

I declare that I have read the Terms and Conditions for this photography competition and agree to abide by them. If I am under 18 my parent/guardian is agreeing below on my behalf.

Declaration *

I Agree

Page Title

Online Form - Historic Photo Competition

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