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 THE FOURTH QUAGGA PRIZE, 2018

 Entry Form


Please copy and complete the form in full, sign the declaration and send it with your book and entry fee of  £15.00 to Quagga Books, 2 Leslie Gardens, Sutton, Surrey SM2 6QU 

 

Book Title ---------------------------------------------------------------------------------------------

 

Author -------------------------------------------------------------------------------------------------

 

Date of Publication -------------------------------------------------

 

ISBN -------------------------------------------------

 

Your Name in Full -----------------------------------------------------------------------------------

 

Your Postal Address ---------------------------------------------------------------------------------

 

Your email Address ----------------------------------------------------------------------------------

 

(Contact details will not be disclosed without your permission)


Declaration:


I declare that I am an Independent (self-published) author and that I have read the terms and conditions for The Quagga Prize, 2018, and that my book is entirely my own work

 

Signature --------------------------------------------------------------------------------------------------

 

 

Please tick the source of information about the Prize: Press ad, Word of Mouth, Online ad, Writing Group, Other (specify)

Please email davejames_writer@hotmail.com for a copy of the entry form for The Quagga Prize 2018.