The Moth Short Story Prize Entry Form 2024

Name: ....................................................................................................

Address: ...................................................................................................

Email: ...................................................................................................

Tel: .....................................................................................................

Number of stories: ................................................................................................

Names of stories: ..................................................................................................

.....................................................................................................

How did you hear about the prize: ........................................................................

Please do not include these details on the pages with the stories.

Method of payment:

Cheque or cash | €15 per story □

Postal order (Ireland only) | €15 per story □

Credit or debit card via PayPal (payment to enquiries@themothmagazine.com) | €15 per story □

Final issue of The Moth | €7 (Ireland/UK) □ €8 (Europe) □ €10 (ROW) □

Back issue of The Moth | €5 □

Gift bundle The Moth (5 back issues) | €20 (IRL/UK) □
Gift bundle The Moth (5 back issues) | €28 (Europe) □

Gift bundle The Moth (5 back issues) | €32 (ROW) □

Digital issue of The Moth | €4 □

Total ...............................

Please read the rules before sending your story to:

The Moth Short Story Prize 2023

Ardan Grange

Milltown

Belturbet

Co. Cavan

Ireland H14 K768