2007 ENTRY FORM
Anson County Writers' Club Youth Prose/Poetry Contest
Entry form must be submitted with each contest entry)

NAME _________________________________________________

ADDRESS _____________________________________________

SCHOOL ______________________________________________

GRADE _______________________________________________

CATEGORY ____________________________________________

TITLE OF WORK ________________________________________

PARENT or TEACHER'S SIGNATURE ________________________

I certify that this is my own work.

SIGNED _______________________________________________

___ (Optional) Please check if you wish possible inclusion in future anthology.)

I hereby grant the Anson County Writers' Club permission to publish this work in a future Anson County anthology. I understand that all rights to the work will revert to the author following publication.


SIGNED _______________________________________________
                                        (Parent or Guardian's Signature)

Entries are due by 5:30 p.m. on Friday, December 7, 2007.

COPIES OF THIS FORM ARE ACCEPTABLE