CASE DISTRICT VIII RECOGNITION PROGRAM OFFICIAL ENTRY FORM

CASE DISTRICT VIII RECOGNITION PROGRAM OFFICIAL ENTRY FORM

PLEASE READ THESE INSTRUCTIONS before filling out your online entry.
Please complete this form for entries in only ONE category and subcategory. Print the form, save a copy for your records, and submit one copy with your entry to the judges.

If you have entries for MULTIPLE categories, you may use this form to complete payment for all categories (input just one main category and subcateory). You must submit a completed entry form as downloadable from this site for each category. Remember to include the payment verfication number on your form, and send the completed forms to the judging coordinators for the appropriate categories

Entries must arrive at the Judging Coordinator’s location by Wednesday, November 16, 2005.

Misdirected or incomplete entries cannot be considered. Please mail early.

Entry fee: $35 (US funds) per entry.

If you are having any problems with this form please send an email to brenda.briggs@ualberta.ca

Name(s) and title(s) of person(s) to be credited:
Please seperate each name with a comma (Name - title,)

Name of person submitting entry:

Institution:

Department:

Street Address:

City:

State/Province:

ZIP/PC:

Phone:

E-mail:

Number of entries submitted in the category to be handled by this CASE Judging Coordinator
$35 (US funds) per entry.

Institution’s Enrollment:

Entry Category:
	Publications	Periodicals	Visual Design, Illustration, Photo
	Writing	Projects	Electronic Media
Subcategory & Section: [ie. Student Audiences 3(a) ] :

Type of institution: (choose all that apply)
	Public	Private	Four-year	Two-Year
	Secondary	Independent	Other

Entry Title:

Date Produced:
(xx/xx/xxxx)

External or outside costs incurred, which could include design, photography, consultation, free-lancers, contract services, printing, but exclude tax, mailing, and postage expenses. Please indicate if these costs are in U.S. or Canadian dollars.
Estimated cost/piece: $ OR Total Budget/Cost: $
Quantity produced:

Produced entirely or mostly: (choose one)
Institutional Staff Outside Firm

For Periodicals ONLY, please list the following:
Frequency: Press run:

If you are having any problems with this form please send an email to brenda.briggs@ualberta.ca

CASE
1307 New York Ave., Suite 1000
Washington, DC 20005
202.328.2273