Rhine Research Center: Mysterious Short Story Submission Form

Personal Information
You must be 18 years or older to enter this contest. By clicking this box, you are affirming that you are at least 18 years of age. *
Information About Your Story
My story is: (optional)
My story contains the following elements: (optional)
General Information
I have read and understand the official rules of this contest.  I meet all of the necessary requirements and agree to abide by all rules  for this contest.  VIEW OFFICIAL RULES HERE *
There is a $20 fee to submit your story to this contest (you will be redirected to a payment site when you submit this form): *

DISCLAIMER:  Submitting a story for this contest does not constitute a verification of psychic abilities or the validity of the content of your story.  The Rhine Research Center does not validate psychic abilities and does not offer psychic counseling of any sort. This contest is for entertainment purposes.

Electronic Signature

By typing my name below and submitting this application, I am confirming that all of the information provided in this application is accurate to the best of my knowledge.  I am also expressing an interest in participating in this activity sponsored by the Rhine Research Center. 

I also confirm that I understand that although there is no such thing as complete privacy when it comes to using the internet, all information provided on this application will be considered confidential and will be securely maintained by the Rhine Research Center.  The  Rhine Research Center, and all of the employees and associates of this center will be held harmless in the event of an inadvertent breach of confidentiality. 

If you wish to pay by check, please contact the Rhine at 919-309-4600.  Please reference the Rhine Mysterious Short Story contest and the amount of your payment.
I am interested in receiving additional information via email the Rhine Research Center, activities, and events.

All information is the sole property of the Rhine Research Center and cannot be reproduced or reused without the expressed written permission of the Rhine Research Center.