The 2003 Natali Prize - Application Form

Print out this form, fill it in and fax or mail it along with a copy of your article if you submit an article from the printed press. If you submit an article from the on-line press, print out this form, fill it in and fax or mail it along with a copy of the article in HTML format on a floppy disk or a CD-ROM, or copy the application form into the body of an e-mail, fill it in and e-mail it to projects@ifj.org along with a copy of your article in HTML format or a URL to the article submitted.


Please read the Rules of the Competition before submitting your entry.


Entries should be at collection points by 31 May 2003.


All entries should be clearly marked The 2003 Natali Prize for Journalism.





Personal details of the entrant (or the team leader in case of group submission)


Name:





On behalf of (if group submission):





Nationality:





Home address:









Home phone:





Home fax:





Personal e-mail:





Professional title:





Professional experience:

















Entry


Title of the article submitted:





Newspaper / website where the article was published:





Date of publication:





Brief description of the article and its impact:





















Newspaper / website where the article was published


Office address:









Phone:





Fax:





E-mail:





URL:





Range and nature of newspaper / website:













Declaration of the entrant


I hereby declare that this entry is my original work, apart from sub-editorial/production treatment, and confirm that I have complied with all copyright requirements and that I have read and understood the Rules of the Competition.


Signature of entrant:

Date: