WWCR First Anniversary Claims Form 2nd If you are human, leave this field blank. #1. Fill out and submit this form and then: #2 Call us at: 443-413-1596 First Name* Last Name* Primary Email* Home/Cell Phone* I am a published author currently writing on a new book.* I am a citizen of the United States or Canada, who is at least 18 years of age and am currently writing a new book. I attest to the truthfulness and accuracy of the personal information provided herein and hereby incorporate it into the Affidavit of Eligibility and Standard Release forms below.* I attest to the truthfulness and accuracy of the personal information I have provided on this form and hereby incorporate it into the Affidavit of Eligibility and Standard Release forms below. I wish to bring a guest and will pay for his/her meals I wish to bring a guest and will pay for his/her meals. Total cost: $207.90 (tax/tip included. My deposit: $104.00) Please read carefully and then approve each of the following documents: Affidavit of Eligibility* I agree to terms and conditions of Affidavit of Eligibility (read) Standard Release Form Affidavit of Eligibility (read)* I agree to terms and conditions of Standard Release Form (read) Upload headshot of yourself (color digital image) for promotional purposes. * Submit