YES! Although I am unable to attend, I would like to participate in the 2004 International Society of Poets' Spring Convention and Symposium--the largest gathering of poets in history. I am submitting one of my poems (up to 40 lines) to be presented aloud at the convention by a professional poetry reader, and to be displayed in printed form in a special room accessible to all convention attendees.

Please immediately send me my Outstanding Achievement in Poetry Silver Award Bowl (a $200.00 value), my bronze Commemorative Award Medallion (a $40.00 value), and my Full One Year Membership into the International Society of Poets for 2004 (a $60.00 value), including my personalized membership card, an ISP patch and decal, entry into special contests and a subscription to The Poet's Corner. If I am already an ISP member, my membership benefits will be extended an additional year.

Please charge my credit card $169.00 (plus $18.00 shipping and insurance) to cover the costs of presenting my poem at the convention in my absence and all shipping, handling, and insurance costs to Federal Express these extremely bulky and heavy awards to me. My satisfaction is guaranteed by your 100% money-back guarantee. If for any reason I am not 100% satisfied with my awards, I may return them within 60 days for a full refund. I understand I will also receive a $100.00 gift certificate off the registration of a future convention so that my poetic accomplishments can be formally recognized in person at a date that is convenient for me.

First
Name:

Last
Name:

Address:

(Address
 cont'd):

City:

State/
Province:


(US & Canada only)

Country:

Zip:

Card
Type:

 

Card
Number:

Email:

Exp. Date:

(mm/yy)

 

 

I wish my name to appear on my award exactly as follows:

 

Title:

Dedication:

Poem:
(up to
40 lines)


If you experience difficulty ordering, please call (410) 356-2000 Ext. 101

 

 

 

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