Fractional Life Awards 2012

Please note each entry to the Fractional Life Awards costs £200 plus VAT and can be paid at the end of your submission via PayPal. If this is not suitable, call +44 (0)20 8340 7989 to make a payment using a credit card over the telephone. We do not accept any other form of payment.

Name of award you are entering (one per entry form):

Name of person /developer / Club or service provider entered:

Company name:

Website:

Contact's name:

Contact's job title:

Contact's full telephone number (including country code):

Contact's email address:

If this entry is being submitted on behalf of a developer by a third party (for example a PR consultancy) please provide contact details for the person responsible for this entry:

Name:

Job Title:

Company:

Email: