ESSP 2005 Entry Form By Kate Whiteside ESSP 2005 Entry Form Please Print. Use black or blue ink. Must accompany entry. Only one entry.

Thank you.

Name: _____________________________________________.

Date of Birth (dd/mm/yyyy)_____________________________________________.

Address: _____________________________________________.

_____________________________________________.

Town/City: _____________________________________________ .

County: _____________________________________________.

Postal Code: ____________________.

Phone Day: ______________________.

Evening: _______________________ .

Mobile: _________________________________.

Email: __________________________________.

Website:_________________________________.

Entry Title: _________________________________________.

Entry Type: _____Short Story ___Poem.

Deadline: Entries must be received by Friday, January 7, 2005.

All entries must be typed, single-spaced, 12 point font, one side of page only.

I am the sole and original author of the piece submitted. It is unpublished and has not won, or been entered in any other competitions. I agree to participate in any publicity attached to the competition and have my works published on the sponsors' web sites. I accept the judges' decisions are final.

Remember: Do not put your name on the submission, only on this form.

Signature: __________________________________ .

Date: ______________ .

Entries should be posted with the completed entry form to: The Web Editor, The Westmorland Gazette, 1 Wainwright's Yard, Kendal, Cumbria LA9 4DP or 25 Market Street, Ulverston, Cumbria LA12 7LR