National Media Award Entry Form National Media Award Entry Form Step 1 of 5 20% IntroductionWelcome to the entry form for SAVE's National Media Award for Excellence in Reporting on Suicide. Please complete this form in it's entirety. Incomplete forms will not be eligible for judging. If you have any questions about your entry or this form, please contact the Program Manager at save@save.org. Please be sure to read fully the Official Award Entry Rules and Regulations before getting started (www.save.org/mediaaward).Please verify your age.* I am 18 years of age or older. I am 17 years of age AND have completed the Minor Applicant Participation Form. If you are 17, you will upload your completed Minor Applicant Participation Form next. To download and complete this form, go to www.save.org/mediaaward.If applicable, upload the completed Minor Applicant Participation Form.Max. file size: 10 MB. Entrant InformationI am applying as... An individual A group (collaboration) A media organization If applying as a group or media organization, please select a primary contact to complete the entry. Name* First Last Name of media organization* Email* Phone*Mailing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country If you win, this address will be used to send the award. Entry DetailsTell us about your entry.Select an entry category.* Category 1- Print Publications Category 2- Online Publications Category 3- Broadcasts (audio/video) Select the primary medium in which the story was published or broadcast.* Television Radio Podcast Newspaper Magazine Online Select the option that best describes the content or style of your publication or broadcast.* Newscast Breaking news Investigative report Hard news Continuing coverage News series Feature report News documentary Current issues Does your publication or broadcast aim to accomplish any of the following? Select all that apply.* Educate the public Raise awareness Counter negative stereotypes or stigma Provide suicide prevention information or resources Encourage people to seek help Promote that treatment works None of the above Entry SummaryPlease include a 300-500 word summary of your entry.* Upload Your EntryUpload PRINT or ONLINE PDFs here.Accepted file types: pdf, Max. file size: 10 MB.You may also submit a live link to the publication, but it is not required if you choose to upload a copy.Copy and paste URL where judges can view your publication or broadcast. If submitting a URL for a publication, you may want to also consider uploading a PDF in the event your article is removed from a live URL.If your broadcast or online publication is listed as private, please include any login information necessary to access your entry. Login Password If your publication or broadcast is in another language, please upload an English translation here (PDF format only, please).Accepted file types: pdf, Max. file size: 10 MB.Publication InformationDate your entry was first published or broadcast.* MM slash DD slash YYYY Please list the name(s) of the media organization(s), network(s) or station(s) that published or that broadcast your entry.*Attach any letters of complaint, corrections or retractions that are relevant to the judging process.Max. file size: 10 MB.PDF only. Confirmation of EntryI hereby certify and represent that I have read the Official Award Entry Rules and Regulations and fully understand the meaning and effect thereof and, intending to be legally bound, I submit this entry.* Yes Electronic Signature- Please type full legal name.* Today's date* MM slash DD slash YYYY MarketingHow did you hear about the SAVE National Media Award?* SAVE Facebook page Facebook ad Google ad SAVE website Instagram page Instagram ad Google search Word of mouth