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The Moth Art Prize Entry Form 2022 Name: .................................................................................................... Address: .................................................................................................... Email: .................................................................................................... Tel: .................................................................................................... Number of pieces: .................................................................................................... (max of 10 per entry)
Where did you hear about the prize?: .................................................................... Purchasing: Entry to Moth Art Prize 20 □ Annual subscription to The Moth 28 (IRL/UK) □ Annual subscription to The Moth 32 (Europe) □
Annual subscription to The Moth 40 (ROW) □
Annual subscription to The Moth (digital) 24 □ Current issue of The Moth 7 (IRL/UK) □ Current issue of The Moth 8 (EUROPE) □ Current issue of The Moth 10 (ROW) □
Cheque or cash □ Money or postal order □ PayPal transaction ID: Total ...............................
Please read the rules before sending your portfolio to mothartprize@themothmagazine.com or: The Moth Art Prize The Moth Ardan Grange Milltown Belturbet Co. Cavan Ireland H14 K768
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