ENTRY FORM
A completed entry form must accompany each entry (please photocopy as required). Please ensure that you have clearly labelled each entry with your company
name and the category name.
DEADLINE FOR ENTRIES: FRIDAY 30TH JULY 2004
Please post the completed entry form, along with your submission to: Lizzie Dekkers, Interactive Marketing & Advertising Awards 2004, C/o Centaur Events,
St Giles House, 50 Poland Street, London, W1F 7AX.
T
; 020 7970 4772,
F
; 020 7970 4797,
E
; ima.awards@centaur.co.uk
CONTACT DETAILS
Who is supplying the entrant's details?
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Agency
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Client
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Other
Contact Name* Job Title
Company Name
Address
Postcode County
Telephone Fax Email
Signature
Date
*This will be our contact throughout the awards
AWARD CATEGORIES
Please tick the category you wish to enter
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Finance
2
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Automotive
3
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Consumer Products and Services
4
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Technology
5
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Travel
6
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Entertainment
7
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Best Use of Rich Media
8
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Best Use of Search Marketing
9
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Best Use of Viral Marketing
10
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Best Use of E-mail
11
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Best Use of Wireless
12
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Best Use of Interactive TV
13
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Best Use of Multiple Channels
14
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Special Award for Technological Innovation
15
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Agency of the Year
IN THE EVENT THAT YOU SHOULD BE SUCCESSFUL, PLEASE INDICATE BELOW (PAYING PARTICULAR ATTENTION TO CAPITAL LETTERS);
How your project name should be represented when written as text;
How the client company name should be represented when written as text;
How the agency company name should be represented when written as text;
PAYMENT DETAILS
The cost of an entry is £65 + VAT (£76.38)
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I enclose a cheque made payable to Centaur Events for £ ___________
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Please debit my credit card by £___________
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Access
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Amex
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Switch
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Visa/Mastercard
Please note billing address must be the same as mailing address
Card Number
Name on Card
Issue Number (Switch only)
Valid Date
Expiry Date
Signature
Date
We would like to keep you up to date with relevant Centaur products and services including information about forthcoming events. Please write to the Circulation Director at St Giles House, 50 Poland Street, London, W1F 7AX if you
specifically do not want to receive this information.
