Entry Form
(Dream Quest One Poetry & Writing Contest - SUMMER 2012)
*Postmark
deadline is: July 31, 2012
Make personal
checks, cashiers 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
Name:_____________________________________________________________________________
Address:___________________________________________________________________________
City/Province:_______________________________________________________________________
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)
*Postmark deadline: July 31,
2012. All poetry and writing contest winners will be notified, announced and published online in the Dare to Dream pages,
on August 31, 2012.
