Entry Form (Form can be cut and pasted to a white background)

Full Name______________________________

Address_______________________________

              _______________________________

              _______________________________

              _______________________________

Email Address_________________________

Telephone # (s)  (      )______________________

                            (      )______________________

 How did you hear about Writingcompetition.com?   

          Internet Search_____

          Email Ad_____

          Magazine/Newpaper Ad _____  Which magazine/newspaper?____________________

          Flyer_____

          Word of mouth_____

          Other _____  Please specify_________________________

Checklist:

     Entry (beginning with the proper opening line, 250 words or less!  Please post word count at the top of the page.)  _______

     Completed entry form                                                                                                                                                                    _______

     Payment (25$--check or money order)                                                                                                                                        _______

     Self-addressed, stamped envelope                                                                                                                                             _______

Mail Entries to:

Writingcompetition.com

P.O. Box 495944

Chicago, IL 60649-5944