Author Information
1.	Author's Name
2.	Address City State Zip Code
3.	Home Telephone Number
School Information
4.	Current Grade (as of today's date).			Your Age (as of today's date).
5.	School's Name (optional)
6.	Teacher's Name (optional)
7.	School's Address (optional) City State Zip Code School's Phone Number
8.	Who recommended this writing competition to you? (check one)
	parent	teacher	tutor	other
Your Submission
9.	Title of Submission (please read this note about a title)
10.	Submission Genre: (select one only) Poetry Short Story
11.	Please select the Eligibility Group Level for which you are entering your submission (select one only): Group A: Grades 2 and 3 Group B: Grades 4 and 5 Group C: Grades 6, 7, and 8 Group D: Grades 9, 10, 11, and 12
We encourage students to compose their submission in a word processing document, then copy and paste into the brown box. • Please type the word “END” after the last line in your submission. This will confirm for us that all of the text was pasted into the box. • There is no limit on the amount of words you can paste into the box. The box will expand. Paste your submission below the line. _________________________________

Type parent or guardian’s e-mail address in the blue box below (required here or your entry will not be received.)



Parent or Guardian Consent (parent or guardian, please check this box and type name below after reading the “Terms and Conditions”)



Almost done - important reminders:

› You must complete all of the above fields, especially the e-mail fields.

› A confirmation e-mail will be sent to you in about five days or less from the date you submit your form.

› Your entry is not complete until you click the Submit Form Now button below.