Public Safety Writers Association
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| Entrant Information | Entry No. (leave blank) __________ | ||
| Name | |||
| Address | |||
| City/State/Zip | |||
| Phone | E-Mail Address | ||
| Title of Work Submitted | |||
| Entry Information | |||
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Category: Fiction: Book Short Story Flash Nonfiction:
Book
Creative Non-Technical
Creative Technical |
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| Has this work been published? Yes No | |||
| If published, when, where, and by whom? | |||
| Do you have any comments you would like to add about this work? | |||
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If I win an award, I
would like a press release sent to the following publication(s):
I affirm that this is my original, unedited work.* |
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| I enclose a check or money order for $10, made payable to the Public Safety Writers Association. | |||
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Signature: _____________________________ |
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| Date submitted: | |||
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Please submit this form
(each entry must have a separate entry form, although several entries may
be submitted in the same envelope or package) to:
Public Safety Writers Writing Competition |
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*In the case of work published in a newspaper or magazine, we realize that your work may have been edited to some extent, but the work must bear your byline and be substantially your unedited work. |
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