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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
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