Entry Form
ING Media Awards Entry Form
Use this form, or a photocopy, for each contest entry. Date__________________________________________
Name ______________________________________________________________________________________________________
Birthdate # (i.e. March 9, 1981 birthdate would be written as 030981) _________________________________________________
Address, City, State, Zip _______________________________________________________________________________________
Telephone ____________________________________ Contest Category ________________________________________________
Title of Entry ________________________________________________________________________________________________
E-mail address ________________________________________________________________________________________________
Where published/broadcast & date ________________________________________________________________________________
Hometown Newspaper _________________________________________________________________________________________
Rules checklist:
_____ Publication date and publication name on at least one copy; _____ If multiple byline, all are ING members; _____ Entry form for each individual entry;
_____ All copies on letter-size paper; _____ Correct number of copies included (4); _____ No more than two entries per category; _____ Each individual copy of entry clearly marked with category name and birthdate number (i.e. February 1, 1952 birthdate would be written as 020152. This will be your personal identification number).
Other details
• Only entries published/aired between October 1 of the previous year and September 30 of the current year are eligible. • Final entry deadline is October 1 (postmark) for all categories except the book category, which is September 7. • No entry fee is required.
Send entries to: ING Media Awards, 483 Montgomery Place, Altamonte Springs, FL 32714
