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The Moth Short Story Prize Entry Form
Name: ...............................................................................................
Address: ...............................................................................................
Email: ...............................................................................................
Tel: ................................................................................................
No. of stories: ................................................................................................
Names of stories: ................................................................................................
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Please do not include these details on the pages with the stories.
Method of payment:
Cheque or cash (made payable to 'The Moth Magazine Ltd.') €8 □
Money or postal order (made payable to 'The Moth Magazine Ltd.') €9 □
Credit or debit card via PayPal (payment to enquiries@themothmagazine.com) €8 □
Annual subscription to The Moth €20 □
Total ...............................
Please read the RULES before sending your story to:
The Moth Short Story Prize
The Moth
81 Church Street
Cavan
Co. Cavan
Ireland
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