Name
Mailing Address  
                           
Email Address   
If you wish to use a pseudonym, instead of your own name, for author and copyright credit enter the name here:    
My story was previously published:   Yes         No      If yes, enter year published, to be used for copyright notice:  
Mystery/Crime etc-          Sci-Fi         Other/General Fiction-        Poem-     

Short BIO (optional): 

Please publish BIO with my story/poem (check box):    Yes        No  
Publish the following email address with story/poem:   
If none given emails sent to the Editor at OPM will be forwarded to you.
If my story/poem is selected for publication, I would like my photo included with my BIO
and story/poem:   Yes         No       Do not send photo until asked.

Title of Story/Poem:  
Approximate Word Count:  

If Short Story, paste synopsis here:

If Poem, paste poem here:

I have read the Submission Guidelines and agree to the terms and conditions set forth therein for publication of my story or poem if selected for publication (check box):   Yes         No