Please Print A Copy Before You Hit "Submit!"

BOOK INFORMATION

Please classify your book and enter it in the following categories. Multiple entries must be
accompanied by a separate $50 fee for each book.
* Category Entered:
* Title:
* Publisher:
Author:
Editor:
* Brief description of your book
APPLICANT INFORMATION
* Applicant's Name:
Mailing Address:
Contact Phone:
* E-Mail:
* How did you hear about this festival?
* If you place in the competition, would you be interested in purchasing promotional items?
Yes No
* Would you like to be a part of our mailing list?
Yes No
* Would you be interested in purchasing a detailed critique of your work by our judges?
Yes No
* How do you wish to pay for your entry?
Online (PAYPAL)
Offline (Check or money order payable to: JM Northern Media LLC)
  * I certify that I am 18 years of age or older. I understand that applications must be accompanied by a non-refundable entry fee via check, money order or PayPal online payment of $50 in U.S. dollars for  each submission.


Please Print a Copy of This Form Before You Hit Submit!