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Entry Form

  Annex 1

  Entry Form

  Participant (name or company name): ______________________________________________ 

      ______________________________________________________________________________        

  Address: ______________________________________________________________________ 

      ______________________________________________________________________________        

  City: _________________________________________________________________________

  Postcode: _____________________________________________________________________

  Country: ______________________________________________________________________

  Telephone: (country, city, area code) _______________________________________________

  Fax: __________________________________________________________________________

  E-mail: ________________________________________________________________________

  Creator(s): _____________________________________________________________________

  Professional title: ________________________________________________________________

  Contact person: _________________________________________________________________

  Mascot name: __________________________________________________________________  

        Creative rationale: _______________________________________________________________

        ______________________________________________________________________________    

        ______________________________________________________________________________   

        ______________________________________________________________________________ 

        ______________________________________________________________________________    

  

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