Competition

2013 Entry Form for Open Age Categories

Personal Details

All fields are required.

First Name

Surname

Address

City

State

Postcode (or ZIP code)

Country

Phone #

Entry Details

Entry Fee: $5.00 per entry

Title of Entry

Entry Category

I am a Qld. resident with email access & would like to be considered for the Poetry Mentorship.

Please type (or paste) your poem into the box below.

Optional Survey

Is this the first time you have entered this competition? Yes No

How did you hear about the competition?