PEACEFUL PASSAGES

Sunday, September 29, 2002 o 8:00 AM to 5:00 PM
Ramada Regency Palace / Mt. Laurel, New Jersey

STORY SUBMIT FORM
(Please print this page and mail with your payment to 'send to' address indicated below)

Name_______________________________________________________________________________

Address_____________________________________________________________________________

____________________________________________________________________________________

Phone / Email / Fax____________________________________________________________________

I grant permission for Marilee Tolen and the Peaceful Passages Project to use, publish, and distribute this story. I understand that the story that I submitted will be edited and the names of persons used will be limited to the first name and last initial.

Name (your name printed)_______________________________________________________________

Signature (your signature)________________________________________________________________

Please send this completed and signed form and your 250-word story (ASAP!) to:

Send to: Peaceful Passages
Plaza Office Center Suite 102
560 Fellowship Road
Mt. Laurel, New Jersey 08054

Peacefully, Expectantly, and Gratefully yours,
Marilee Tolen and The Committee for Peaceful Passages

Contact Information / Phone: (856) 727-8181 • www.peacefulpassages.org