The First Ever
WicCon

ISTEDDFOD

No.______________
for office use only

Entry Form
Please print or type clearly.

Name(s): ____________________________________________ Telephone: ______-______-_________

Address: ____________________________________________ email: ___________________________

City, ST Zip ________________________________________

Circle total number of entries per category:     Poetry:   1   2        Short Story:   1   2        Music:   1   2
(no more than two (2) entries per category)           (Circle Return if you want tape/cd returned)

Description of each piece: ___________________________________________________________________

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I (we) certify that the enclosed entry (entries) is (are) our original, unpublished work(s). I (we) have read and understand the contest rules and entry instructions as contained on the preceding/passthrough webpage and agree that the decision of the judges is final.

________________________________________________
Signature (with Date)

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Signature (with Date)

Entries must be sent to:
Eisteddfod Entries
PO Box 8246
Portland OR 97207-8246


All questions concerning the contest and/or results should be directed to the above address or to eisteddfod@wiccon.org.