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CONTEST ENTRY FORM

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Please fill in the information below and remember to check type of entry - prose/poetry.
* fields are required

We will confirm that your entry and payment have been received via email.

Contest Entry Form
*
*First Name
*Last Name
*Street Address
Street Address
*City
*Province/State
*Country
*Postal/Zip Code
Telephone
*Email
* Bio
(Maximum characters: 250)
You have characters left.
*Manuscript Title(s)
* Enclosed is my original work. It has not been published, produced, submitted elsewhere in any form, or entered simultaneously in another contest. Please confirm.
*Date day/month/year
File Attachment Please note that only 1 file can be uploaded so the entire contest entry must be inside that file
*File Attachment
Acceptable file/doc/docx
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