Stanley Plumly Tribute Feature Contributor

Your Legal Name *

First

Middle

Last

Pen Name (if different from above)

First

Middle

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Phone *

Author Photo

Drag & Drop Files, Choose Files to Upload

Please upload a jpg or png file with a resolution of 72 dpi. File should not exceed 128 MB.

Preferred Pronouns

Contributor Note *

Website

Twitter

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Instagram