2013/2014

UIA Architecture & Children Golden Cubes Awards Entry For

!"ne entry #or by cate$ory%

&a e o# 'ro(ect) *y+e o# 'ro(ect acti,ity/ E,ent/ 'ublication) -ocation) .ate/s) Award Cate$ory) (Please tick one box only) /C0"" I&/*I*U*I"& 12I**E& 3E.IA AU.I" 4I/UA3E.IA

&a e o# Entrant) (This may be an individual or an organisation) Address o# Entrant)

Contact &a e) 'hone) E ail) I attach) 1 copy of a A2 paper printed poster (rolled), set out in the Awards Template format. 2 copies of a CD containing the 1 X A2 poster set out in the Awards Template format and digital files for each of the elements of which it is composed (drawings, photographs, te t). A sample of the original materials (!oo", tool, game, film, disc, acti#ity programme, etc.) in the form and language in which it was produced. I declare that ) The $ntrant is not a %&erson 'neligi!le( under the terms of the Award )egulations. The pro*ect is the wor" of the $ntrant, that they hold the copyright and that they ha#e o!tained all necessary consents to its su!mission for the Award .ate 3obile) 1eb)

+ame , /i$nature (person responsi!le for su!mitting $ntry)

5our Entry should be sent to the UIA 3e ber /ection in your country6 A complete list of -'A .em!er /ections can !e found at0 www.uia1architectes.org2en23ui1sommes1nous2un1reseau