The Sixth Act
Playwriting Contest Submission Form

(Please Print Legibly)

Name:	_________________________________________________________________

Student M-Number: _____________________________________________________

Street Address: _______________________________________________________

City: ________________________ State: _____________ Zip: ______________

Phone Number(s): ______________________________________________________ 

E-mail(s): ____________________________________________________________

Title of play: ________________________________________________________

Word Count: _____________

How did you hear about the contest?  _________________________________

I verify that the above information is correct, that the play is original and previously unpublished.  I give MCC permission to submit my work to the national contest and to publish my work in any campus publication.  I give permission for my work to be performed/read publicly at the award event, if selected.  

______________________________________________
Signature

The Sixth Act’s decisions are final.  
Feedback will not be given to individuals on their work. 
No work will be returned.