Entry Form

Please ensure that you have read the rules before submitting your entry.

Name:
Address:
 
 
 
Email Address:
I agree for correspondence to be sent to me by e-mail, as this will not only save time but money for the award:
Phone Number:
Name of Story:
 
I enclose €5.00/£4.00Stg/US$6.00 administration fee:
Please Note: Eurocheques (also known as traveller cheques with an EC logo) are no longer acceptable. Please do not confuse these with personal cheques made out in the new Euro currency.
I have read and understand the competition rules:
Please make sure you do read them, as we really don't want to disquallify anyone after all your hard work.
Signed:
Date:

Entries must be submitted postally. Please use a separate entry form for each story you submit. Print out the above form and send it with two copies of your story and €5.00/£4.00Stg/US$6.00 administration fee to the following address:

The James White Award
211 Black Horse Avenue
Dublin 7
Ireland