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