Charles Rischbieth JURY Poetry Prize Application Form

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Declaration

I declare that the information I have supplied on this form is true and correct to the best of my knowledge. I understand that if I am awarded the prize and the University of Adelaide at any time thereafter forms the reasonable view that my application included false or misleading information or documentation, I authorise the University of Adelaide to obtain such additional information deemed necessary to assess my application for this prize
I understand that the University of Adelaide will not use or disclose any information supplied on the application form or obtained for the selection process without my written consent, other than for the selection process of this prize (which may include disclosure to third parties such as donors). All such information will be managed in accordance with the University of Adelaide Privacy Policy and Management plan available at http://www.adelaide.edu.au/policies/62.