[Whether you use the electronic option to submit your ms. entry or the traditional mail option, this form must be mailed by regular first class post.]

Title of Entry: __________________________________________________________________
Entrant's Name (no pseudonyms): __________________________________________________
If part of a team, partner's name: ___________________________________________________
Address: ______________________________________________________________________
City: __________________State: _____________________________
Country: ____________ Zip:________________
Telephone: Day:( ) Evening:( )________ _ E-mail:________________ _

I have read and understand the official rules of WisRWA's FABULOUS FIVE writing contest. I realize and accept that manuscript judging is subjective and agree to abide by the decision of any judges and/or contest officials and shall hold harmless WisRWA, its contest personnel and/or judges for any and all disputes arising from contest rulings or decisions, and/or disputes arising from circumstances beyond the control of contest officials, such as any entries lost in USPS mail. Contestant's Signature:________________________________________________________

RWA member? Yes___ RWA# No___________
WisRWA member? Yes _No________

Identify method of payment:

• Check (provide check number & amount)___________________________________
• Money Order (number & amount) _________________________________________
• PayPal (transaction ID number and amount) _______________________________

_______ I have submitted my entry electronically to category & coordinator listed below:

Check appropriate category and email/mail to the corresponding coordinator:

______Historical: Marilyn Auer, 1849 N. 72nd Street, Wauwatosa, WI 53213-2353; marilynauer@juno.com
______Erotic Romance: De Anne Wildes-Mickelson, 713 Moreland Avenue, Schofield, WI  54476; dr67tm66@gmail.com
______Series ContemporyLong/Short: Helen Johannes, 512 W. Cleveland St., Marshfield, WI 54449; johannes54449@yahoo.com
______Single Title: Karen Miller, 11322 Western Avenue, Cedarburg, WI 53012; kmillerx@wi.rr.com
______Romantic Suspense: Jamie Kersten, 520 Adams Street, Wausau, WI 54403; mommustwrite@gmail.com
______Paranormal: Ann M. Curtis, 4735 Nora Lane, Madison, WI 53711; anncurtisFab5@gmail.com
______Woman's Fiction: Jody Allen, 302 S. 11th Avenue, West Bend, WI 53095; fab5contest@gmail.com 

If your chosen category should be cancelled, do you want us to place it in another category? Y N
If yes, please identify your second choice from the list above: ______________________________

Please circle how you heard about the FAB 5 contest. RWR; Website; Email loop; Other writer; Other source
______________________________________________________________________________

Coordinator Use Only: Date Rec'd: _____________

Amount Paid: $ ______________ Check #__________________ PayPal confirmation: __________

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