Group Entry Form

SPRING STAMPEX 2011 STAMP ACTIVE COMPETITION

CLUB / GROUP ENTRY FORM

Generously sponsored by the Great Britain Philatelic Society

NAME OF CLUB / GROUP ....................................................................................................................

ADDRESS..............................................................................................................................................

.......................................................................................................POSTCODE......................................

NAME OF CLUB LEADER......................................................................................................................

TELEPHONE NO.....................................................E-MAIL.......................................................................

TITLE OF ENTRY........................................................................................................................................

NO. OF PAGES.........................

HAS THIS EXHIBIT BEEN ENTERED BEFORE IN A STAMP COMPETITION ?

YES[ ] NO[ ]

IF YES, WHERE AND WHEN..........................................................................................

AWARD RECEIVED.......................................................................................................

NAMES OF PARTICIPATING JUNIORS plus AGE (AS AT JANUARY 1, 2011) -

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Declaration: These entrants understand the rules for this competition. This entry is their own work.

Signed by Club leader..............................................................................Date............................................