 Printer friendly version
The Moth Nature Writing Prize Entry Form 2023 Name: .................................................................................................... Address: .................................................................................................... Email: .................................................................................................... Tel: .................................................................................................... Number of entries: .................................................................................................... Names of entries: .................................................................................................... .................................................................................................... .................................................................................................... .................................................................................................... .................................................................................................... .................................................................................................... Please do not include these details on the pages with the entries. Method of payment: Cheque or cash (15 per entry) □ Money or postal order (15 per entry) □ The Moth gift bundle of 5 (Ireland/UK) 20 □ The Moth gift bundle of 5 (Europe) 28 □ The Moth gift bundle of 5 (ROW) 32 □
Final issue of The Moth 7 (Ireland/UK) □ 8 (Europe) □ 10 (ROW) □ Digital issue of The Moth 4 □
Total ...............................
Please send your entries to: The Moth Ardan Grange Milltown Belturbet Co. Cavan Ireland
|
