Poetry Contest Prize Redemption Form

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Name *

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Name of Contest *

Address where you would like your prize shipped *

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You are entitled to a free gift card OR a free poetry book. Choose one: *

If you would like a free gift card, choose from one of the following below: *

If you would like a free poetry book, choose from one of the of the following below: *

You are entitled to free promo on our site. Complete the section below:

What is the name of the book you want us to promote? *

Insert Book Synopsis *

Insert Book Purchase Link *

Attach Book Cover *

Max file size: 20MB

Insert 3rd Person Author Bio *

Attach Recent Head Shot *

Max file size: 20MB

Sign *

Date *

Woud you like to support Dream Pathways Kids by donating a children's book or $1 dollar? *

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