GREAT AMERICAN SONG CONTEST
ENTRY FORM

(Please PRINT CLEARLY)

Name:____________________________________________

Address:__________________________________________

City _______________State/Province: _______ Zip _______

Telephone: ________________ E-mail:_________________

Signature: ________________________________________
(I state that I am the writer or co-writer of the songs or lyrics I've entered.)

NOTE: The same song may be entered in multiple categories. A separate entry fee is required for each.
There is no limit on the number of songs you may enter.

Song Title 1: ____________________ Song Title 3:_________________________
Category: ______________________ Category: ___________________________
Writer(s): _______________________ Writer(s): __________________________

Song Title 2: ____________________ Song Title 4:_________________________
Category: ______________________ Category: ___________________________
Writer(s): _______________________ Writer(s): __________________________

                                                               PLEASE CHECK:  [ ]  Mail my evaluations / SASE enclosed. (Refer to RULES)
                                                             [ ]
 Don't bother to mail my evaluations.

Number of entries:
(First 2 entries:) _________ x $30 =  ______
(After first 2:) ___________ x $25 = ______
TOTAL : _____________________________
     * Save $5 per Entry! No Evaluation option

* Make checks & money orders out to: Songwriters Resource Network
Mail entry form, fees & materials to: Great American Song Contest,
PMB 135, 6327-C SW Capitol Hill Hwy., Portland OR 97239
( Option: click here to print GASC mailing label )

* Postmark deadline is Dec. 7, 2005 *

CATEGORIES:


To pay by credit card, click button below:

PLEASE NOTE: Since most people mail in their tapes and CDs, it's often easiest to include payment (check or money order) with the songs and keep everything together in one entry package. However, if you prefer to pay by credit card, simply click the above logo. You'll be directed to the free services of PayPal. Please be sure to print out your payment receipt and include it with your entry package when you mail us your songs & entry form!

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