BLODWEN JERMAN PRIZE

PROJECT

ENTRY FORM

NAME OF CANDIDATE ……………………………………..

CANDIDATE’S HOME ADDRESS …………………………

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SCHOOL OR INSTITUTION TO WHICH CANDIDATE IS OR WAS ATTACHED (with Address)

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TITLE OF PROJECT ..…………………………………………

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FORMAT (eg essay, report, video, etc) ………………………………

NAME AND STATUS OF TEACHER OR OTHER OFFICIAL PERSON CERTIFYING THIS IS INDEPENDENT WORK

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This form should be accompanied by the required certification, signed and including contactable address.

Please return completed application to:

Professor M.E. Chamberlain (Chairman of Trustees), Department of History, Swansea University, Singleton Park, Swansea, SA2 8PP