Entry Form

All India Poetry Competition Among School Children,2004

(The Poetry Society, India. L67A Malviya Nagar, New Delhi. Ph-91-11-24619325)

    

 Name (In Block letter)             ---------------------------------------------------------------------

Name and Address of School  ---------------------------------------------------------------------

                                                ---------------------------------------------------------------------

 

 Residential Address:                ---------------------------------------------------------------------

                                                ---------------------------------------------------------------------

 Tel. No:                                   ---------------------------------------------------------------------

                                                 

 Sex:                                         Male/Female                Nationality: Indian/NRI/Others

(Tick which ever is applicable)

 

 Date of Birth:                           ----------------------   Class:               ------------------------

 

 Contact Number:                     ----------------------   Email:               ------------------------

 

 Mother Tongue                       ----------------------

 

 I wish to enter the following poem (s) for the All India Poetry Competition Among School Children, 2004

 Titles (in block letters)

                                    -------------------------------------------------------------------------------

                                    -------------------------------------------------------------------------------

                                    -------------------------------------------------------------------------------

                                    -------------------------------------------------------------------------------

                                    -------------------------------------------------------------------------------

                                    -------------------------------------------------------------------------------

                                    -------------------------------------------------------------------------------

            (If you require more space, write or type the titles of the poems on a separate sheet of paper and attach

            it to this form)

  Declaration 

 I have read and completed the checklist overleaf. I have paid Rs. ------------------------ to my school towards the Entry fee. I have read and I accept all the conditions of entry.

Rs. ------------ No of titles --------.

 DD No/PO No.          -----------------------------------------------

  Name and Bank          -----------------------------------------------

  Date                            -----------------------------------------------

  Name                          ----------------------------------------------   Sign      ------------------------

                                                                                                              Date     ------------------------

 

For office use

 

 Results:

Winning poems will be displayed in both the sites: http://www.indianpoetry.org/ and http://www.indianpoems.com/.

(For Office Use Only)

 Registration Id: --------------------------------       Amount Received.-------------   No Titles. ---------

 Date of Receipt --------------------------------

 Before sending the entries, please read and complete the checklist overleaf.

 

CHECKLIST 

Please read carefully and put a tick in the appropriate boxes below.

   

  1. Poems entered for the competition.

 

  1. Payment for ------paperback/copies of All India Poetry

     Competition Among School Children.

     1998 Anthology at Rs. 100/- per copy.

     1996 Anthology at Rs.100/-per copy.

     (Rates include postage and packing)

 

  1. Payment for ------paperback copies of All India Poetry

     Competition Among School Children.

     2000 Anthology at Rs. 140/- per copy.

     2001 Anthology at Rs.140/-per copy.

     (Rates include postage and packing)

 

  1. Payment for ------paperback copies of All India Poetry

     Competition Among School Children 2003 Anthology at

     Rs. 140/- per copy.                                                      

          (Rates include postage and packing)

 

   All entries, along with the entry forms, should be forwarded by the school and sent to:

            

All-India Poetry Competition Among School Children 2004

            The Poetry Society (India)

            L-67A, Malviya Nagar

            New Delhi 110017, India

            On or before December 31, 2004