HOLT Medallion Judge Application
Email address *
Personal Information
Please fill out the contact information below.
Your name *
Example: Jane Doe
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Country
US residents leave blank.
Your answer
Zip code *
Your answer
Day phone number *
Example: 201-555-1234 (Please use hyphens)
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Evening phone number *
Example: 201-555-1234 (Please use hyphens)
Your answer
Cell phone number
Example: 201-555-1234 (Please use hyphens)
Your answer
Email address *
Please note all correspondence with HOLT Medallion will use this address.
Your answer
Category Selections
Please select the five (5) categories you will be willing to judge and indicate your order of preference. You may receive books in more than one category.
First choice *
Select your 1st choice category
Second choice *
Select your 2nd choice category
Third choice *
Select your 3rd choice category
Fourth choice *
Select your 4th choice category
Fifth choice *
Select your 5th choice category
I am willing to judge more than 5 books. *
If you are willing to judge more than 5 books, please indicate how many books total.
I am willing to judge e-books *
If you choose to receive e-books, please indicate the format you would like.
I am willing to judge tie-breakers *
This may require a quick turnaround toward the end of the contest.
Judge's Agreement *
By submitting this application form, I apply to judge in the 2018 HOLT Medallion Contest and I agree to abide by all rules and policies thereof. This includes the confidentiality agreement, which prohibits the mention of the HOLT Medallion contest in any reviews including but not limited to Amazon, Goodreads, public forums, blogs, or other media. I understand that violation of these rules may result in my being banned from future contests.
Please sign and date below to show your acceptance of the HOLT Medallion Contest Rules.
Your answer
Do you have any special requests regarding being a judge?
Please comment below. We'll do our best to accommodate your request, however due to the large number of judges and entries we receive, we cannot guarantee each special request.
Your answer
Your judge application is not complete until you click the submit button. You will be sent an email with confirmation of your application. If you would like a copy of your responses, please click the button below.
Please complete the captcha before submitting the form.
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