IMPAC – Connecticut State University System

 Young Writers Awards



Entry Form

As for the option to buy cheap articles, it can be easily done with the help of writers at

(Electronic Copies available at and

This form is double-sided.

(Please Print or Type)


      Student Name ___________________________________________

      Complete Address__________________________________________

      City__________________________  State_________________________ Zip Code________________

      e-mail address ________________________________________________
Phone Number ___________________________________________

      Date of Birth ______________________Age______________________

      Nominating Teacher________________________________________

        (print full name)                                  

      School _____________________________________________________

      Complete Address__________________________________________

      City__________________________ State______________________________ Zip Code_____________

      e-mail address _________________________________________________

      County ____________________________________________________

      School Phone Number______________________________________

      Teacher Signature (required) ________________________________


                        Submission Category (circle one):          PROSE                        POETRY

               Title ______________________________________________________

               Number of Pages ___________________________________________


Submit 4 copies of your entry together with this entry form.  Submission must be postmarked by February 1, 2007 and accompanied by this entry form.  Mail to IMPAC—CSU Young Writers Awards, Connecticut State University System,

39 Woodland Street, Hartford, CT 06105-2337.  IMPAC-CSU Young Writers Trust maintains first rights for the written works. Reprint permission may be granted.

Errors on entry form, e.g., wrong county, could result in disqualification.

See reverse side or page 2 for complete entry rules.


Entry Rules


A teacher in a public or private school must nominate entries for the competition.  Home school nominations are also accepted.


Young writers between the ages of 13 and 18 years of age should submit four copies (1 original and 3 copies) of their best single work in poetry or prose; only one entry per student is permitted.  Prose entries may include essays, short stories, reviews, plays, research papers or news articles.  There are no length requirements.


Entries should be typed, double-spaced, on 8½ by 11-inch paper and submitted along with this entry form.  Please number each page of your submission.  Do not place your name on your work of prose or poetry.  Your entry will be confidential when distributed to judges.

Errors on entry form, e.g., wrong county, could result in disqualification.


The entries must be postmarked by February 1, 2007 and submitted to:


IMPAC—CSU Young Writers Awards

Connecticut State University System

39 Woodland Street

Hartford, CT 06105-2337




___     8½ x 11 paper

___     4 copies (one original & 3 copies)

___     typed

___    double-spaced

___     name of author should not appear on the submission

___     pages numbered


Entry Form:

___     Print (legibly) or type (except for teacher signature)

___     County (not country)

___     Age of student: 13, 14, 15, 16, 17 or 18 during school year 2006-2007

___     Teacher signature required

___     Category circled


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