PHOTO EXHIBITION
“AUSTRALIA – VIETNAM: THEN AND NOW”

First Name: _______________ Last name: _________________ Title: Ms/ Mr/ Mrs
Date of birth: ____________________ID / Passport No.: ____________________
Correspondence Address: _____________________________________________________________________ _____________________________________________________________________
Phone: ___________________ Email: __________________________________

Total of submitted entries: ______________(please attach more paper if the provided space below is not enough) 

Image 1: (name)____________________________ taken in (year) ___________ Annotation: ____________________________________________________________ ______________________________________________________________________

Format: in a CD     hard copy       please return hard copy       do not return

Image 2: (name)____________________________ taken in (year) ___________ Annotation:____________________________________________________________ ______________________________________________________________________

Format: in a CD    hard copy        please return hard copy       do not return 

Image 3: (name)____________________________ taken in (year) ___________ Annotation:____________________________________________________________ ______________________________________________________________________

Format: in a CD    hard copy        please return hard copy      do not return 

Consent: By entering this exhibition, I hereby consent the Australian Embassy in Hanoi and Australian Consulate General in Ho Chi Minh city to use any of my entries for the purpose of promoting diplomatic relations between Australia and Vietnam.

Date: ______________________                                ______________________ 
                                                                                                      (Signature)

Print name: _________________________

Enclose this form with your entries and send to one of the below addresses:

Cultural Section                               or              Cultural Section
Australian Embassy                                           Australian Consulate General
8 Dao Tan Street                                               F5 Landmark Building
Hanoi                                                                 5B Ton Duc Thang Street, Dist. 1
Vietnam                                                              Ho Chi Minh City, Vietnam