30/30 Project Application Form Name * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone (###) ### #### Biography * Choose a 30/30 Participation Month Option 1 Option 2 Fundraising Goal Amount $350 $400 $500 Other Book Choice from Tupelo Catalog (excluding books over $25) * Provide three sample poems below: Please cut and paste your poems in the area below. Thank you!
