Your Name:
Address:
(Address Cont'd:)
Home Phone
Email Address

Please indicate number of poems in each contest. Fees are $5 per contest for up to five (5) poems per contest. Additional poems $1 each.

William Stafford	____ poems	$_____
Carlin Aden	____ poems	$_____
Charlie Proctor	____ poems	$_____
Bart Baxter (minimum 2)	____ poems	$_____
Total number of poems	____ poems
Membership		$15.00
	TOTAL PAID	______

(Checks payable to: Washington Poets Association)

WPA reserves the right to publish winning poems in its newsletter and Web site and is granted permission to print Award and Honorable Mention poems in future anthologies.

No poet may win more than one cash prize in any single contest nor re-enter a poem that has won a cash prize in a previous WPA contest. WPA is a private, non-profit organization.