| Newspaper Name: | ||
| Contest Representative: | ||
| Phone: | Fax: | |
| Address: | ||
| City: | State: | Zip Code: |
Fee per entry: $30
Entry fees are non-refundable. Full payment must be received by the contest postmark deadline, February 29, 2008. Invoicing and purchase orders are not accepted.
| Total number of contest entries submitted: | ||
| TOTAL AMOUNT DUE: $ |
Payment by Check: (make payable to FSNE)
| Check number |
Payment by Credit Card:
| Preferred: [ ]Visa [ ]MasterCard [ ]Discover | Acceptable: [ ]American Express | |
| Credit Card Number: | Exp. Date: | |
| Cardholder’s Name: | ||
| Cardholder’s Signature: | ||
| Cardholder’s Billing Address: | ||
| City: | State: | Zip Code: |
| Cardholder’s Phone Number: | ||
| Cardholder’s E-mail: (Receipt will be sent via e-mail) | ||
Contest entries and payment should be sent to:
Robyn Tomlin
FSNE Contest Coordinator
Star-Banner
2121 SW 19th Ave. Rd.
Ocala, FL 34474
Last updated Jan. 3, 2008