This completed form and necessary entry fee is required to be attached to EACH ENTRY. Please print out the number of entry forms you will need for your submissions.
Send your entry to: Pat Middleton, Rt. 1, Stoddard, WI 54658. Make your check payable to: Coulee Region Scribes. Questions? Call Pat at 608-457-2734 or Email pat@greatriver.com
Your Name ________________________________
Your Address________________________________________________________________
Your Phone #______________________________________________
Entry Fee attached $____________
SUBMISSION TITLE CATEGORY ENTERED
#1___________________________________________________________________________
#2___________________________________________________________________________
#3___________________________________________________________________________
#4_________________________________________________________________________
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and Entry Fees.
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