manual entry form (pdf) - Interactive Media Awards

ENTRY FORM 1 2 3 4 5 6 7



This is the company that will appear on the award page

Your company:



I am the site’s: (please select one)



Designer

Webmaster

Advertising, Marketing or PR Firm

Developer

Owner

Corporate Representative

Other:

Project title:





Site URL:



http://

Site language:

English

(please select one)

Spanish German







French

Italian

Portuguese

Polish

Russian

Other:

Site summary: Briefly describe the purpose of your website and your target audience in 300 words or less.

Feel free to attach

a separate piece of paper with your site description.



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username:



password:



Site category(ies):

The same site can be nominated in more than one category (if relevant) and win multiple awards. A separate entry fee applies for each category, and a separate award page will be generated for each category in which the site wins. The entry fee per category is $195 ($125 for nonprofit categories).

A full list of available categories is listed Category 1: on page two of this form.



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This site requires a username and password:



Additional recognition: (optional)





Category 2:



Category 3:



Please provide the names of up to five other individuals or organizations to be credited on your awards page should your entry win an award.

Name:



Role:

S

NTRIE

FOR E

LINE DEAD ER 31 B M DECE

This is the name that will appear on the award page

Your full name:

r e t n enow

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COMPETITION CATEGORIES Current Available Categories (through December 31 entry deadline): Airline Arts/Culture Association (nonprofit) Beauty/Cosmetics Biotechnology Celebrity/Fan Community Consumer Services E-Commerce E-Zine/Newsletter Financial Information Government Health/Nutrition Human Resources Intranet Music Newspaper Personal Pregnancy/Baby Public Relations Real Estate School Search Engine/Directory Teens Training/Vocational

Advertising Advocacy (nonprofit) Architecture/Interior Design B2B Banking Blog Bridal/Weddings Communications Consumer Goods Data Networking Education Employment Entertainment Events Family Healthcare Hotel/Resort Humor Investor Relations Manufacturing News Ratings/Reviews Reference Social Networking Web Design/Development

Auction Building/Construction Charity (nonprofit) Computer Hardware Consulting Energy Fashion/Style Financial Services Games - Industry Hospital Kids Legal Magazine Marketing Natural Environment/Green Pets Pharmaceutical Photography Politics Restaurant Retail Sports Telecommunications Travel/Tourism University

Animals/Wildlife Automobile Catalog College Computer Software Eccentric/Peculiar Food/Beverage Games - Playing Insurance Lifestyle Medical Military Movie/Film Museum Nonprofit Professional Services Radio Recruiting Religion Science/Technology Television Toy/Hobby Transportation Utilities Youth

PAY BY CHECK Checks should be made payable to “Interactive Media Awards, Inc.” and mailed to: Interactive Media Awards, Inc. Award Nomination Department 244 Madison Avenue, Suite 416 New York, NY 10016 USA Payment is preferred in U.S. dollars and drawn on a U.S. bank. For payments in foreign currencies, a US$35 exchange fee must be added.

PAY BY CREDIT CARD Check one:

Visa

MasterCard

American Express

Credit Card Number:

Discover Exp. Date:

Card Security Code:

(MM/YYYY)

BILLING INFORMATION Name Address City State/Province Zip/Postal Code Country Phone Email

AUTHORIZATION I certify that all information provided in this entry form is accurate and honest and I have read the IMA Competition Rules and Legal Statement and understand and accept all the terms and conditions stated therein. Signature Date Interactive Media Awards, Inc. • 244 Madison Avenue, Suite 416 • New York, NY 10016 • USA • (212) 332-9090

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