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 Short Story/Poetry Application


Check one:

_____ GFWC Pennsylvania Clubwoman

_____ Student

     _____Category 1:  Grades 1 - 3                _____Category 3:  Grades 7 - 9

     _____ Category 2:  Grades 4 - 6                _____ Category 4:  Grades 10 - 12

Title of Story/Poem ___________________________________________________________

Name of Contestant ___________________________________________________________

Address ____________________________________________________________________

            _____________________________________________________________________

Phone (     ) _______________________________________

School (if student) ____________________________________________Grade ____________

Sponsoring GFWC Club ________________________________________________________

County ___________________________  District ___________________________

Literature Chairman _____________________________________________________________

Phone (     ) _______________________________E-mail _______________________________

Club Chairman sends one entry per category.  Include three (3) copies of each entry, with Entry Form and Judging Sheet (with name and title of work) for each entry directly to:

 GFWC Pennsylvania Short story & Poetry Chairman

Charlotte Smith

PO Box 167

Zieglerville, PA  19492-0167

Must be postmarked on or before March 1, 2009.