Livingston Awards Finalist Form - Wallace House Center for Journalists

Enter your name exactly how you would like it to appear on promotional materials. *

Upload a copy of your driver's license or passport to verify your date of birth. Label the file with your last name. *

Click or drag a file to this area to upload.

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Cell Phone (best number to reach you) *

Preferred Email *

Social Media Handles *

If selected as a Livingston winner, I agree to participate in a Livingston public event featuring a discussion of my winning story. *

This form defaults to autofill for your convenience. Please review your answers to ensure they are the intended responses to our questions. *