contests :: realizing the dream registration form



 

personal information

 

Email Address:

For Desert Rose Members

First Name:
Last Name:
Address:
City/State/Zip:
Day Phone:
Evening Phone:
RWA® Membership#:

 

Professional Information

 

Desert Rose Member? Yes No
Are you Published ? Yes No
Title of Entry:
Category Entered:

 

Read Carefully Before Entering Your Name and Date

 

I have read and understand the rules of the 2012 Realizing the Dream Contest.

I have sent this work in time for it to arrive between November 1, 2011 and January 31, 2012. If this work becomes contracted on or before January 31, 2012, I will notify the Realizing the Dream Contest Coordinator. My entry will then be returned and I will receive a refund of my entry fee.

I realize and accept that judging is subjective and agree to abide by the decisions of the judges/contest officials. I shall hold harmless the Desert Rose Chapter of RWA, contest personnel and judges for any disputes arising from contest rulings or decisions and/or disputes arriving from circumstances beyond the control of contest officials.

I also declare this to be my own work.
Full Name:
Date:

 

Contest Fee & payment instruction

Instructions for payment will follow after you press the 'SUBMIT' button.

 

Check one: I will pay my dues via PayPal
I will pay my dues by check. Indicate the check Information below:
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Date Mailed:

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