2010 Entry Form
Contact
Company
Address
City/State/Zip
Phone #
Fax #
Email
POSTMARK DEADLINE:
March 12, 2010
For an extension: Call 817-277-4040
or email:
info@hermesawards.com
Pro bono entries
x $0 - $___
0
___ (Must also have paid entry)
Entries
x $60 - $
Campaign/plan entries
x $125 - $
AMCP fee
$25 - $__
25
__
TOTAL
- $
#
CAT#
CLIENT
TITLE OF ENTRY
JUDGE'S USE
1
2
3
4
5
More Entries
Pro Bono
Form A
Payment Options:
Payable in U.S. dollars to Hermes Creative Awards
send payment, entry(ies) and form(s) to:
Check
Visa
MC
Discover
American Express
Government entrants may call for other payment options.
Card #
Exp. Date
Hermes Creative Awards
2320 Superior Dr., Ste A
Arlington, TX 76013
Phone 817-277-4040
CCV Code
(Last 3 digits on back of card, Visa and MC Only.)
Name on Card
Signature
________________________________________________
Cardholder Zip Code
Email Address for Receipt