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NSW Rape Crisis Centre
Poetry and Short Story Competition
Entry Form

Name: ____________________________________________________________

Address: ___________________________________________________________

Suburb: __________________________________ Postcode: _________________

Telephone: _____________________________

Email: _________________________________

Title of Poems:

(1) ________________________________________________________________

(2) ________________________________________________________________

(3) ________________________________________________________________

Title of Short Stories:

(1) ________________________________________________________________

(2) ________________________________________________________________

(3) ________________________________________________________________

Entries must be received by the last post of Friday 30 April 2004

Send entries to:
The Competition Secretary
NSW Rape Crisis Centre
P.O. Box 555
DRUMMOYNE NSW 2047

Please make cheques payable to:
NSW Rape Crisis Centre