1.  Do you agree with the terms outlined in the Submission Guidelines?

Yes  No

2.  Select what form of work are you submitting? (if submitting just artwork, go to question 4.)

Artwork 

Poetry 

Short Story 

Combination (two genres or all of the above)

3.  Enter your submission in the space provided below: (remember to include poem titles and to leave the dashed line with the words POEM END, so we can distinguish between submissions. If you are submitting a short story, you may remove the POEM END lines. Please do not forget to enter a blank line between to indicate paragraphs.)

- - - - - - - - - - Poem End - - - - - - - - - - - - - - - - - - - - Poem End - - - - - - - - - - - - - - - - - - - - Poem End - - - - - - - - - -

4.  Enter your biography in the space provided below: (if you experience any problems, leave your biography blank and remember to check the box below at question 5.)

5.  If you failed to submit a biography along with your submission, please check the box below so someone from The Curious Record can get in contact with you regarding your biography:

        Please contact me in regards to my biography.

6.  If you are submitting artwork, please check the box below so arrangements can be made in regards to delivery:

        I have artwork to submit.

7.  Your Details:

Name:
E-mail:

Pen Name:

Country:
Age:	students only
School:	students only