2007 Insight Writing Contest

Cover Sheet

 

c Student Short Story   c Student Poetry   c General Short Story

 

 

Manuscript Title:                                              

Name:

Pseudonym (if preferred):                                                                                     

Permanent Address:

                                                                                                                                                                            

                                                                                        

Home Phone Number: (        )         

Dorm/School Phone Number: (        )         

Work Phone Number: (        )         

Birth date (month/day/year):                                                

E-mail Address:                                 

Social Security Number (Information needed to process payment upon acceptance):

_____-___-________

 

Gender:  ___Male   ___Female

Ethnicity  (needed for accurate illustrative portrayal):

 

Grade (as of fall of 2007):                                          

Major:                                                                        

School Name & Address (as of fall of 2007):

                                                                                                                                                                             

                                                                             

Home Church Name:                                                                                           

City and State:                                                                                                      

Hobbies, Interests, Other:

                                                                                                                           

                                                                                                                                                

 

This story is unpublished and true. The incidents in this manuscript happened as described.                                                               

Signature __________________________