* Category Entered :
* Title :
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* Brief description of your book:
* Applicant's Name :
Mailing Address :
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make sure it's correct
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* If you place in the competition, would you be interested in purchasing promotional items?
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Offline (Check or money order payable to: JM Northern Media LLC)
* I certify that I am 18 years of age or older. I understand that applications must be accompanied by a non-refundable entry fee via check, money order or PayPal online payment of $50 in U.S. dollars for each submission.
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