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The Moth Nature Writing Prize Entry Form 2022 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) □ Annual subscription to The Moth (Ireland/UK) 28 □ Annual subscription to The Moth (Europe) 32 □ Annual subscription to The Moth (ROW) 40 □
Current 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
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