JOVANOVICH IMAGINATIVE

CREATIVE WRITING AWARD

· Please provide the information requested below and paperclip this form to your manuscript.

· Staple to your manuscript an additional cover sheet that includes only the title and student ID.

· Do not include any personally identifiable information anywhere in your paper.

· The award will be transferred to your university account in May. Randall Fullington will handle arrangements for the financial award. Please be aware that any prize or scholarship awarded through the university may affect any student financial aid package you have received. For more information on this aspect of your award, please contact the Office of Financial Aid.

Please designate the award for which you are applying:

___ Best Graduate Manuscript

___ Best Undergraduate Manuscript

Name: _________________________________________

Phone: _________________________________________

E-mail: _________________________________________

Address: _________________________________________

_________________________________________

The work I am submitting is entirely my own.

Signed: ____________________________________