The 2nd Annual Per Contra Prize

Entry Form (Printable)

 

NAME OF AUTHOR:

 

 

 

ADDRESS OF AUTHOR: (Street address, City, Country, Mailing Code)

 

 

 

 

 

E-mail address:

 

 

 

TITLE OF STORY:

 

 

 

 

NUMBER OF WORDS:

 

 

 

 

I CERTIFY THAT THE ENCLOSED STORY IS MY ORIGINAL WORK, AND THAT IT HAS NEITHER APPEARED IN PRINT OR ELECTRONIC PUBLICATION NOR HAS IT BEEN ACCEPTED FOR PUBLICATION IN PRINT OR ELECTRONIC PUBLICATION, AND THAT I AM 18 YEARS OF AGE OR OLDER. (When the story is the product of a collaboration by two authors, both signatures are required).

 

 

SIGNATURE(S)

 

 

 

 

 

 

CHECKLIST FOR EACH ENTRY:

COMPLETED ENTRY Must include a separate cover sheet for each submission.

 

COVER SHEET: 

      NAME of AUTHOR,

      TITLE OF STORY

      NUMBER OF WORDS

 

MANUSCRIPT: 

            TYPED (GOOD PHOTOCOPIES ARE ACCEPTABLE)

            DOUBLE SPACED

            TITLE ON TOP OF EACH PAGE

            PAGES NUMBERED

            NAME OF AUTHOR ONLY ON COVER SHEET, NOT ELSEWHERE IN MANUSCRIPT

 

ENTRY FEE:

            Cashier's Check or Money Order for $10.00

 

 

 

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