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Entry Form

(Dream Quest One Poetry & Writing Contest - Summer 2016)

*Deadline is: August 17, 2016 at 11:59 PM, CST.

Make personal checks, cashier's checks or money orders payable to:
"DREAMQUESTONE.COM". Cash payments are accepted, but will
be sent at your own risk. All payments must be in the form of US
Currency dollars/funds. Dreamquestone.Com is not responsible for
lost entries.

Date:________________________________________________________

Phone# (optional): _____________________________________________

Age: _______________________

Mail Entries to:                     

Dream Quest One

Poetry & Writing Contest

P.O. Box 3141

Chicago, IL 60654

USA


Name:_____________________________________________________________________________


Address:___________________________________________________________________________


City/Province(s):_______________________________________________________________________


State:______________________________________________________________________________


Postal/Zip code: __________________________________


Country:___________________________________________________________________________


E-mail address (optional):______________________________________________________________________________


Number of Poems: _________             Number of short stories:___________


Total Amount enclosed: $_________  Total Amount enclosed: $___________


Method of Payment
:  Check/Money order ____   Cash____    PayPal____   


Checklist
: Entry: Poem(s)___   Story(ies) ___  Completed Entry Form_____ 

Payment:____       S.A.S.E.____


Brief biographical info: (Please tell us about yourself): 

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(Use additional sheet if necessary)

*The deadline to send all poems and stories is August 17th, 2016 at 11:59PM (CST). All poetry and writing contest winners will be notified and published online in the Dare to Dream pages, on October 9th, 2016.



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