2004 Entry Form        Reference# RS3

(Please print this from your printer) If you do not have access to a printer, you may e-mail: info@songwriting.net or call the 24 hour contest line at (954)776-1577 (NOTE: please make copies of this entry form to submit more entries! Enter as often as you like in as many categories as you wish!)

Name:____________________________________________________________________

Address:__________________________________________________________________

City/State/Zip/Country______________________________________________________

Phone:_____________________________ E-mail (if any)__________________________

Song Title:_________________________________________________________________

Payment Type:   oVISA     oMastercard      oCheck/Money Order

Card number:______________________________ Expiration date (Month/Year):________

Signature:______________________________

Make your check or money order for US$30.00 payable to: USA Songwriting Competition

Check One Category Only:

oPop   oRock/Alternative   oCountry   oR&B 

oGospel/Inspirational   oFolk   oLatin   oInstrumental

oJazz   oHip-Hop/Rap   oChildren   oWorld

oDance/Electronica   oNovelty/Comedy   oLyrics Only

Collaborators/Band Name (if any):_________________________________________________________

I certify that I have read, understood and accept the rules & regulations of the USA Songwriting Competition.

Signature:_______________________ Date:____________

------------------------------------------End of Entry Form---------------------------------------------------

Mail all entries to: USA Songwriting Competition

4331 N. Federal Highway, Suite 403A

Ft. Lauderdale, FL 33308, USA

If this page does not print out properly, please contact: info@songwriting.net

DEADLINE: All entries must be postmarked by May 28 '04 or earlier. Hurry! Enter Now!