Wufoo

Name - (Not Published) * First Last
Not published. There, I said it twice.
Name or Identity You Wan't Me to Credit *

This is any name, ID, handle or whatever I can give a hat tip to when I publish your accepted item so you know it was yours.
Email - (Not Published) *

This is the email address I will send the PayPal payment to.
Address - (Not Published) *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Yep, still not publishing this information. Just really need it in case a regulator wants to get in touch with you if they feel the mailer is really bad and the person that sent it to you needs some special attention.
Anything You Want to Say?

Anything on your mind you feel compelled to share with me? Now's your chance.
Attach Your Files to Upload

You can zip your files into one zip file. I'm looking for good quality scanned images. Prefer color scans or great photographs of at least 150 dpi or higher.
Attach a File
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I'd Like to Do Good and Donate My Payment to AmeriCares
Yes

You don't have to do this but it's a nice thing to do to help others.
I Agree to the I Buy Junk Mail program and site terms. *
Yes

You have to agree to the program and site terms to submit. When you submit you will be added to my weekday newsletter email so you can see when your submission is published. You can always unsubscribed with one click at any time.
Do Not Fill This Out