THE 4TH (2014) LAMPARA BOOKS CHILDRENS STORY WRITING CONTEST

APPLICATION FORM
PEN NAME OF PARTICIPANT: ______________________________
REAL NAME:____________________________________________________
CURRENT RESIDENTIAL ADDRESS: ________________________________
CONTACT ADDRESSES:
LANDLINE: ____________________ MOBILE PHONE: _____________
EMAIL: ______________________________
BIRTHDATE: ____________________
GENDER: ____________________ CIVIL STATUS: ____________________
COMPANY AFFILIATED WITH: _____________________________________
ADDRESS: ______________________________________________________
CONTACT ADDRESSES:
LANDLINE: ____________________ EMAIL: _____________________
POSITION: _____________________________________________________
HIGHEST EDUCATIONAL ATTAINMENT: ____________________________
SCHOOLS ATTENDED:
GRADUATE SCHOOL: ______________________________________
DEGREE/S: _________________________________________
COLLEGE/UNIVERSITY: ____________________________________
COURSE/S: _________________________________________
HIGH SCHOOL: ____________________________________________
ELEMENTARY: ____________________________________________
PUBLISHED WORKS (childrens books)
1. _______________________________________________________
2. _______________________________________________________
3. _______________________________________________________
4. _______________________________________________________
5. _______________________________________________________

I certify that all the above information are true and correct.

______________________________________________
(Signature, Date)
NB: Entries must be received on or before 14 November 2014.
Judging is on 28 November 2014.
See www.lamparabooks.com.ph for details.
Per DTI-FTEB SPD Permit # 1652 Series of 2014.