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Name (in block capitals, with surname underlined):
________________________________________________________________________
________________________________________________________________________
Address (in block capitals):
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Telephone number:______________________________________________________
Email address:__________________________________________________________
Date of birth:___________________________________________________________
Name and address of adult referee if you are under 18:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
I wish to enter translations of the following poems
(including title, original author, original language for each poem entered):
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Where did you first hear of the prize?
________________________________________________________________________
I am a British resident or British citizen and I enclose a cheque or postal order
payable to the Stephen Spender Memorial Trust for:
£________________________________________(entrants 18 or under enter for free)
I have read and accepted all the conditions of entry:
Signed:_________________________________________________________________
Dated:__________________________________________________________________
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