OMDC Magazine Fund Jury Application Form

If you are interested in putting your name forward to serve on an OMDC program jury please complete this application form and submit to OMDC by Wednesday, June 23, 2010.

Instructions
After responding to all of the questions below, please click “preview” to review and print a copy of your application for your records. If you note any errors on the preview page you will have the opportunity to return to the entry page to make necessary corrections. Once you click “submit” on the preview page you will not be permitted to make further adjustments.

Note: There is no save function that will allow you to save the information that you have entered and return to make changes at a later date. Please ensure that you have the required information on hand and have allocated enough time to complete all of the questions below. You will also be required to attach your resume.

Page 1 of 1
Name: Title: Company: Address: Telephone: Email: Website: Please tell us why you are interested in serving on an OMDC program jury? Please declare any reason or relationship with a potential applicant (publishing company or project) that might create a real or perceived conflict of interest. Please attach/upload your resume. Please list two industry references: (name, company, tel, email)