Green Award Info Form | Headliners Foundation of Texas

Charles E. Green Award Info Form

The philosophy of the journalism competitions sponsored by the Headliners Foundation is to reward individual journalists. Please complete this form for each person to receive a check (maximum of five). If more than one person is to receive a check, the contest award will be divided equally, unless you specify otherwise. It is the policy of the Headliners Foundation of Texas that cash funds to journalists for their award-winning work be made payable to an individual or team of individuals who produced the entry. In the event a media outlet disallows such payment, the award funds will not be distributed and will instead be utilized by the Foundation to fund journalism education. Award winners will still receive non-monetary recognition from the Foundation.
If you will be receiving $600 or more from the Foundation, you must also submit an IRS Form W9, which may be found here. Please upload your completed W9 form below.
Upload W9 form here.

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Name*

First NameLast Name
Media Outlet*
Charles E. Green Award Winner in Which Category?*
Choose ONE
Work Contact Information
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
Home Contact Information

Unless otherwise requested, we will mail your award check to this address.

Charles E. Green Award Info Form