2008 CIPA TECH Awards
(This form must be used for all TECH award entries)

Entry Form
(Tape this form to the inside cover of each entry)

 

TECH Category  
Entered by:   Author             Publisher          Service Provider
Fee Paid: $50   $30   $25
Publisher  
Name of Service Provider  
Contact Name  
Phone Number  
Mailing Address  
City, State, Zip Code  ,                           
Email address  
Book Title  
Author  
Publication Date