JACK LONDON FOUNDATION, INC.
                         WRITING CONTEST ENTRY FORM

Please Print: 

Contestant’s Name                                                                                                              

Street Address                                                                                                                    

City                                                        State                           Zip                                    

Telephone #(         )          -                         E-Mail                                                             

Grade level                     Future educational plans (optional)                                               

                                                                                                                                          
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Name of Instructor                                                                                                             

Name of School                                                                                                                 

Street Address                                                                                                                   

City                                                                     State                      Zip                            

School Phone # (           )            -                  E-Mail                                                          
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Tile of Manuscript                                                                                                              

Word Count:                            (Limit 2000)

Mail completed entry form and manuscript to:
            Jack London Foundation
            P.O. Box 337
            Glen Ellen, CA 95442