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Word Count:

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Title:

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Author's Name:

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Professional, Business or School Affiliation:

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Address:

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Business or School Address:

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Telephone Numbers: Day

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Evening:

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Fax Number:

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E-mail:

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Three Personal References, Addresses, Phone Numbers:

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For High School Entry, Sponsor:

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Phone:

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Teacher Sponsor:

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Phone:

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I have read and understand all rules of The Pirate's Alley Faulkner Society, Inc. governing the competition for the Society's prizes for creative writing. I guarantee that the work here submitted meets all criteria established in the competition rules and that I will abide by these rules in the future if the work submitted is determined to be the winner. I agree to bear any and all costs should a revocation of said prize become necessary because I have failed to abide by all of the rules set forth. The Pirate's Alley Faulkner Society reserves the right to publish in journals, in news releases and in limited-edition booklets or broadsides, excerpts from entries selected as finalists in the competition. The Faulker Society reserves the right to publish winning material in its journal, The Double Dealer. With regard to publishing excerpts, if it's a short story, essay, or poem, we publish the entire piece; if a novel-in-progress, we publish the winning excerpt; for novella or novel, we consult with author to select excerpts. Authors are allowed to make changes, improvements, prior to publication in our journal. We have one-time rights for publication in the Society's journal, which has an approximate distribution of 2,000, and a planned anthology
15 Years of Winners (working title) The anthology would be a repeat of excerpts already published in our journal and would be a collector's item, limited distribution book for major sponsors of our organization.The Society also publishes from time to time shsort excerpts of winning manuscripts of 250 to 500 words in Double Dealer features formatted specifically to use as an education resource for creative writing teachers. Reprints of such features are given free to creative writing teachers for their classes. The Society also has published limited-edition broadsides for gifts to sponsors and limited sales to offset the costs of printing. The Society's earnings from any such published materials will be used for future literary prizes and for the Society's educational projects. No honorarium will be paid to authors. No earnings from any such publications are expected. I hereby give the Society rights to publish portions of my work if I am a finalist or winner. and to publicize my participation in the competition and, in the event I am selected as a winner, my participation in the awards festivities at the Society's annual meeting on November each year. It is understood that promotion of the competition and awards festivities will encompass use of all types of media, electronic and print, and that said promotion will be for the benefit of the Society and its educational projects. It is understood that no honoraria or fees will be paid for promotion of an author's participation in the competition or the Society's annual meeting.

Name:

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Signature:

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Date:

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