A printable version of the application form is available to download here.
Name of Broadcaster (station, channel, website)
Name of Producer
Name of Station Manager
Transmission Date
Transmission Time
Estimated Audience
Duration
Broadcast Title
Brief description and reason for nomination (this description will help the judges make their decision)
Category
Media Type
An additional award exists for producers and / or presenters who were 25 or under at the time of first transmission. Entrants to other categories who qualify for the Under 25 award are automatically nominated in this category.
Please tick if the Producer or Presenter qualifies for the under 25 award
Name and Address for Correspondence
Telephone
Email
We will need a clearly labelled off-air CD or DVD of your entry plus written evidence of transmission. We will be unable to consider any entries (including CDs) received after 5pm on 11th May 2012.
Please send a clearly labelled CD or DVD of your programme with a copy of this entry form to:
Jerusalem Awards Allington House 150 Victoria Street London SW1E 5AE