Photo Competition Entry Form

THE MUSEUM OF THE BROADS
PHOTOGRAPHIC COMPETITION 2010 ENTRY FORM
THEME -- " Spirit of The Broads"

Each entry must be 8" x 6" and mounted on card 10" x 8"
Each entry to be accompanied by a completed entry form.

Title of Print ............................................................................................
Date taken .................................
Where taken ............................................................................................

Class Adult / Child (under 13 at time of taking photograph).
For under 13 class Date of Birth ............................

Name ...............................................................................................
Address ................................................................................................
................................................................................................
................................................Post Code...............................
Tel. No. .......................................
e-mail ...............................................................................................

I agree that my photograph may be displayed at the Museum and be used in promotional material subsequently by the Museum. (Acknowledgement of the source will be made). YES / NO Please delete as appropriate.
I enclose entry fee(s) £2 plus additional entries £1 each. Total £............
Cheques payable to -- " The Museum of The Broads".

Signed.......................................................... If under 13 to be signed by responsible adult.

Please print Name .......................................

It is intended to use some of the entries in a calendar to be sold at the Museum. Any entrant whose photo is so used will receive a copy of the calendar.

Entries to be received at the Museum by 13th. September 2010.
Entries will be retained by the Museum.
Send to-- The Museum of The Broads, The Staithe, Stalham, Norfolk NR12 9DA.
Tel. no. 01692 581681

All proceeds are for Museum funds. Reg Charity No. 1036734
For Museum use Entry rec'd Date ................ Fee............... By............