Weber State University

Ogden, Utah

First and Last Name:
Date of Entry

Categories of Entry:	Titles of Works Entered
Short Fiction
Flash Fiction
Non-Fiction
Creative Non-Fiction
Poetry
*Please include title in heading of each page of work, number pages of your submission. Do NOT include author’s name on individual manuscripts.

Under which do you qualify as a Nontraditional Student (chack all that apply)	25+ years in age Married Parent

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Phone Numbers	Mobile: Home:
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Weber State University, 1107 University Circle, Ogden, Utah 84408-1107,