Entry Fee : $10.00 Canadian funds included with submission
NSF cheques result in immediate disqualification from competition
Made payable to: Friends of Dutton - Dunwich
P.O. Box 58 Dutton, Ontario N0L1J0
Story Title : _____________________________________________________
Author : _____________________________________________________
Street Address : _____________________________________________________
P.O. Box : _____________________________________________________
City : ___________________________________________
Province : _____________
E-Mail address : _____________________________________________________
Word Count : _____________
I do affirm that my entry is my own previously unpublished work of fiction
and that I am a Canadian author.
I hereby grant the Friends of Dutton-Dunwich permission to publish
any winning entry
of mine
along with some form of contact information
as supplied by me on the John Kenneth Galbraith Literary Award website
__________________________________________________
signature date