Contest Form

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Entry Form

NAME:

Mailing Address(optional)

City St Zip

E-mail address:

Day Phone:

Evening Phone:

Category for submission:

Have you ever been published?

Yes No

If so, when?

What type of literary work?

Publisher:

Name of published work?

Are you the original owner of this work?

Yes No

If you answered no, who is the owner

Are you at least 18 years of age?

Yes No

Do we have permission to reprint your work if selected as a winner?

Yes No

You must submit your literary work of 1,500 words or less along with this form by fax, mail, or e-mail. Completed work must be submitted in the following formats; MS Word, WordPerfect, text file, or typewritten and double-spaced.

Fax:	(281)596-0028
Mail:	P.O. Box 440341 Houston, TX 77244-0341
E-mail:	writerscontest@writershelpdesk.com