LAND Writing Contest

Liberal Arts Network for Development

Fall 2009

Entry Transmittal Form

Student’s Name: _______________

Student number: _______________

Home Address: ________________

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Telephone number: _____________

e-mail address: _______________

Entry Title : ____________________

Category (delete the two that don’t apply)     Fiction         Essay          Poetry

The entrant acknowledges that filling out this form and submitting this entry constitutes affirmation of the following statement:

I accept the designation as an entrant to the LAND Writing Contest for 2009. I am the author of the attached entry. I grant LAND the right to publish my entry in print and/or electronically. 

Sponsoring College & Address

          _____________

          _____________

          _____________

          _____________

Name of Sponsoring Instructor: _________________

Instructor’s telephone number: _________

Instructor’s e-mail address: ___________

The sponsoring instructor acknowledges that filling out this form and submitting this entry constitutes affirmation of the following statement:

I attest that the attached entry was written by the student whose student number appears on the cover sheet.