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Brimbank Writers Awards Entry Form 2017

Key Contact
Please provide details for the key contact for administration and planning of this event
First Name(*)
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Last Name(*)
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Age(*)
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Postcode(*)
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Contact mobile number(*)
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Email address(*)
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What is your connection to the City of Brimbank? (ie. live, work, study, recreate, use public services, etc.)(*)
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Event Details
Please select the following event you are interested in being involved in(*)

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1.) Event 1 - Author/emerging writers panel event
This event is open to authors and emerging writers who would like to showcase their published work in a panel style format. Each speaker will be required to speak up to 30 minutes about their work.
Please name and briefly describe the piece of writing you would like to discuss (200 words max)
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When and where was it published?
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Please choose which date you are available
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2.) Event 2 - Open event
This event is open to individuals and community groups, and can include workshops, performances, public readings, book launches or exhibitions
Proposed Event Name:
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Details of proposed event (200 words max):
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Target age group/demographic:
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Outline your experience and skills that will help you to manage this event (200 words max):
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Material and venue requirements:
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Do you have any accessibility requirements we can assist with?
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Confirmation
Please read and confirm the following by ticking each box:(*)

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