OFFICIAL ENTRY FORM - 2017 Writers-Editors Network Writing Competition

A separate form must accompany each entry; photocopy before completing for multiple entries; or print out at www.writers-editors.com/Writers/Contests/Entry_Form/entry_form.htm Postmark Deadline: March 15, 2017.

1. Author's  name _____________________________________________________________

Note how you want your name on Winners List/Certificate if different from above:_____________________________

2. Author's mailing address ____________________________________________________________________

___________________________________________________________________________________________

3. Author's phone number (______) ____________ 4. Email: ___________________________________________

5. TITLE of entry ______________________________________________________________________________

6. FIRST LINE of entry ________________________________________________________________________
(This helps us match entry to author when multiple entries have same titles it happens.)

7. Check or Circle Category of this entry:    / / A-Fiction      / / B-Nonfiction       / / C-Children's -  / / D-Poetry

8. ENTRY FEE (check one and enclose fee with entry and entry form):
(Membership number if entering as a current Writers-Editors Network[WEN] member [includes FFWA]: _________)

/  /$5, I am a current WEN/FFWA member or am joining at this time (dues enclosed), and entry is one poem
/  /$10, I am not a member and am not joining at this time, and entry is one poem
/  /$10, I am a current WEN/FFWA member or am joining at this time (dues enclosed), and entry = three poems
/  /$15, I am not a member and am not joining at this time and entry = three poems
/  /$10, I am a current WEN/FFWA member or joining at this time (dues enclosed), and entry is Fiction or Nonfiction or Children's (story or article or book chapter)
/  /$20, I am not a member and am not joining at this time and entry is Fiction or Nonfiction or Children's (story or article or book chapter)

Make entry fee check or money order payable to: CNW Publishing. One check may be written to cover multiple entries if all are mailed in same package (but enclose separate entry forms for each entry). (US $ only)

You may charge your entry fee(s) to: VISA,  MasterCard, Discover, American Express if in USA or Canada. Charge will appear on your card statement as "CNW Pub," and a receipt will be emailed to you by Square, our credit card processor. International, Canada and U.S.  entrants can also pay via PayPal - send entry fees to writers.editors@gmail.com.

Card # _________________________________________ expiration date. _______ Security (CVV) code: ______

card zip/postal code: _______ (important; card will not be approved without zip/postal code on your credit card statement)

Total charged $__________ credit card signature ____________________________________

/ / Entry fee sent via PayPal from (if PayPal account name different from entrant) __________________________

9. SEND entry form(s), with entry or entries & fees, to: CNW Pub/FFWA, PO Box A, North Stratford NH 03590 by postmark deadline of March 15, 2017.

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