2021 Award entry form

Please ensure you have read the terms and conditions governing the Colin Roderick Award prior to completing this form.

A $25 entry fee applies to all submissions and will be processed on the second page of this entry form.

NOTE: If you intend to submit more than one title into the awards, please contact us if you would like to pay for all submissions in a single transaction.

Author details
Street, City, State, Postcode
Date of original impression *
Publisher details
Submitted by *
Submitter details (if different from author or publisher)
Relationship to author
Declaration
Declaration * Ensure you have read the terms and conditions governing the award.