Application Form

Please complete all fields marked with ※.

Your name

Pen Name

Date of birth

Year

Month

Date

Division

*Those who are 12 years of age or under as of April 1, 2019, are entitled to apply for the Junior Division.

Age

Gender

Nationality

Residence address

Phone number

E-mail

Work title1

Entry1 ×
Work title2

Entry2 ×
Work title3

Entry3 ×
Work title4

Entry4 ×
Work title5

Entry5 ×
How many times have you applied for this competition, including this one?



How did you find about this competition?
 















Comments about yourself

【Handling of copyrights】

Entries must not infringe on the copyrights, portrait rights, or other rights of third parties.
The City of Kitakyushu as the organizer will own the copyrights of all entries.

【Handling of personal information】

All applicants will be deemed to have agreed to the terms of this contest upon submission of their works to the contest.
Personal information on all applicants will be handled properly in compliance with the Act on the Protection of Personal Information and no personal information on any applicants will be used for purposes other than the Kitakyushu International Manga Competition.