Entry Form
Please print out the form below and fill in using capitals.
Alternatively copy and paste to Word (or another word processor) and print out once it is completed.
Please send your submission and receipt of payment to:
The Rubery Book Award
PO Box 15821
Birmingham
B31 9EA
UK.
Full name...............................................................................................................................................................
Address..................................................................................................................................................................
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Country...................................................................................................................................................................
Telephone..............................................................................................................................................................
Email .....................................................................................................................................................................
Payment method and date paid.............................................................................................................................
Title of book..........................................................................................................................................................
Author (or pseudonym)..........................................................................................................................................
Publisher...............................................................................................................................................................
Type of book (e.g. Fiction, young adult, Children’s, poetry, How-to book etc)
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Where did you hear about the Rubery Book Award? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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