Flash Fiction Registration Form

Information about the Author

Name:
Address:
Phone number:
Email:
Please provide a website address /email address for people interested in your
work:
Please provide a 50-word biography explaining who you are and what you do
as an author:
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Information about the Story (one entry per person)

Title:
Year:

My story is attached to this email as a Word document and it matches the

specifications as outlined in the Contest Rules.
I consent to being video recorded reading my story for broadcast on air
and social media if my story is selected. I will be available to do so at
some point between September 20 30, 2016.

Note:
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By entering this contest, I acknowledge that I have read all Contest Rules, and I
grant permission to Northern Public Radio to use my name and writing and to
reprint, copy, distribute, publish, archive, broadcast and otherwise use my work,
and any derivative works created therefrom, in whole or in part, for any
purpose. I understand that I retain my right to use and publish my work. I allow
Northern Public Radio to contact me with information about future
programming.

Signature:
Date:

Email this completed form and an original short story saved as a Word
document to wnijflashfictioncontest@gmail.com.
All eligible entries must be received by 11:59 p.m., Monday, September 12, 2016.