MANGA JIMAN / YONKOMA MANGA 2015 OFFICIAL ENTRY FORM CAPITALS. PLEASE COMPLETE THE ENTRY FORM IN BLACK INK USING BLOCK Title: Forename: Surname: Which competition MANGA JIMAN are you entering? YONKOMA MANGA (Please tick one box only) Pen name (if applicable): Postal Address (including Postcode): Daytime / mobile telephone Email: number: Title of manga entry: Number of pages: What is your reference to in this manga? ‘bright young things’/「青春」 Nationality: Date of Birth: Under the age of 18: yes no Signature of entrant:* Name of parent/guardian if entrant under the age of 18:† Signature of parent/guardian:‡ Relationship of parent/guardian to entrant: Postal address of parent/guardian: Daytime telephone number of parent/guardian: Mobile telephone number of parent/guardian: Email: *I accept the terms and conditions of the MANGA JIMAN / YONKOMA MANGA COMPETITION RULES & REGULATIONS – the case that the winner of Manga Jiman Competition is under the age of eighteen (18), he or she must be accompanied by his †In or her legal guardian or parent or have the consent of his or her parent(s)/guardian(s) to travel with someone else. accept the terms and conditions of the MANGA JIMAN / YONKOMA MANGA COMPETITION RULES & REGULATIONS ‡I – For queries and further details, please contact: MANGA JIMAN COMPETITION 2015, Embassy of Japan, 101-104 Piccadilly, London W1J 7JT [t] 020 7465 6589 [e] [w] www.uk.emb-japan.go.jp
MANGA JIMAN / YONKOMA MANGA 2015 OFFICIAL ENTRY FORM PLEASE COMPLETE THE ENTRY FORM IN BLACK INK USING BLOCK CAPITALS. Title: Forename: Surname: Which competition are you entering? (Please tick one box only) MANGA JIMAN YONKOMA MANGA Pen name (if applicable): Postal Address (including Postcode): Daytime / mobile telephone number: Email: Title of manga entry: Number of pages: What is your reference to ‘bright young things’/「青春」 in this manga? Nationality: Date of Birth: Under the age of 18: yes no Signature of entrant:* Name of parent/guardian if entrant under the age of 18:† Signature of parent/guardian:‡ Relationship of parent/guardian to entrant: Postal address of parent/guardian: Daytime telephone number of parent/guardian: Mobile telephone number of parent/guardian: Email: *I accept the terms and conditions of the MANGA JIMAN / YONKOMA MANGA COMPETITION – RULES & REGULATIONS †In the case that the winner of Manga Jiman Competition is under the age of eighteen (18), he or she must be accompanied by his or her legal guardian or parent or have the consent of his or her parent(s)/guardian(s) to travel with someone else. ‡I accept the terms and conditions of the MANGA JIMAN / YONKOMA MANGA COMPETITION – RULES & REGULATIONS For queries and further details, please contact: MANGA JIMAN COMPETITION 2015, Embassy of Japan, 101-104 Piccadilly, London W1J 7JT [t] 020 7465 6589 [e] [w] www.uk.emb-japan.go.jp
2015_COMPETITION_ENTRY_FORM.docx