space

Playwriting Competition
Registration Form 


Please complete the following form.
One Per Person

Registration Form

Step 1                                         Registrant Information
Name:
Address:
City:
State:
Zip:
Daytime Phone:
Email:
Title of Play:
Description:
Author Biography (100 words):

Select your theatre affiliation:

Theatre's name:
Do we have your permission to add your script to the MTA Playwright's Directory? See the directory here.
Step 2                    

Playwriting Competition Fee

Enter Total Amount Due:
Step 3               If you are paying by Check, you may skip this step and Proceed to Step 4
 
Credit Card Holder Information
*Name:
*Address:
*City:
*State:
*Zip:
*Daytime Phone:
Credit card information:
*Credit card:
*Account number:
*3-digit verification: last 3 numbers above signature on the back of Card
*Expiration date: Month
Year

Amount of order to be charged to Card

.00
Step 4                                    Finalize Registraion by Clicking Below
Checks and scripts should be sent to:
MTA
c/o Stephen Cunetto
1247 Bardwell Road
Starkville, MS 39759