ENTRY FORM:
Name______________________________________________________
Address_____________________________________________________
State/prov________ ZIP/PC _______________
Phone( )_____________
e-mail_______________________________________________________
I ____________________ am entering (title(s))_____________________
@ $6.13 per entry for the Halloween writing contest sponsored by Rusty
Bumper. I acknowledge that the piece(s) submitted are my original and
previously unpublished work. I agree to the terms and conditions as stated
for this contest.
Signature_________________________________
Date:____________________________________
Name______________________________________________________
Address_____________________________________________________
State/prov________ ZIP/PC _______________
Phone( )_____________
e-mail_______________________________________________________
I ____________________ am entering (title(s))_____________________
@ $6.13 per entry for the Halloween writing contest sponsored by Rusty
Bumper. I acknowledge that the piece(s) submitted are my original and
previously unpublished work. I agree to the terms and conditions as stated
for this contest.
Signature_________________________________
Date:____________________________________
| Rusty Bumper |
| Halloween Writing Contest 2009 |
| Halloween Writing Contest c/o Rusty Bumper P.O. Box 8171 Holland MI 49422 |
| Mail to: |