Short Story/Poetry Application
_____ 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.