09 Entryform Pdf
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IMAGES OF YOUTH 2009 VIDEO FESTIVAL
ENTRY FORM Must be Postmarked by
April 17, 2009
Title of video: _______________________________________________ Length: ____: ____
(Up to 5:00 including credits)
Student producer’s name as it would appear on an award: _____________________________________________________ (If more than one student producer’s name is to appear on an award, please list their name(s) and information on a separate sheet)
Grade: ______ Age: _______ Address: ________________________________________________________________________ City: _____________________________ State: ________ Zip Code: _______________________ Phone: ___________________________ Email:_________________________________________ Name School/Organization: _________________________________________________________ Address: __________________________City: ____________ State: _____ Zip Code: _________ Teacher/Sponsor: (please print first & last name) ___________________________________________ Phone: (Work)_____________________________ (Home or cell) __________________________ Email: ____________________________________ Signature: _____________________________ CHECK THE ONE TOPIC THAT BEST REFLECTS THE THEME OF YOUR PRODUCTION Advertising
Heroes
Alcohol, tobacco and other drugs
Love/Relationships
Body Image
Media
Cultural Identity
Politics
Education
Racism
Environment
Stereotyping
Global/Social Issues
Violence
Health
Other? (explain in statement)
IMPORTANT - PLEASE CHECK OFF THAT YOU HAVE COMPLETED AND ENCLOSED EVERYTHING YOU NEED. SEE FESTIVAL GUIDELINES FOR ANY ITEM YOU DON’T UNDERSTAND.
___ ___ ___ ___ ___ ___
My/our entry is on a DVD-R format disc playable in a home DVD player. The disc is labeled on the top in Sharpie with title, my name, and phone number. A statement (up to 100 words) about my/our video is on the back of this form. The soundtrack is original? (Original soundtracks will receive extra consideration). A Permission/Release form for EACH student producer is included. My entry is appropriate as described in the Festival Guidelines.
• • •
Mail entries to JENNIFER SLACK, 3723 19TH AVE SW, SEATTLE, WA 98106 All DVDs become the property of Action for Media Education FIND COPIES OF ENTRY AND PERMISSION FORMS AT THE AME WEBSITE: http://www.action4mediaeducation.org/projects.html Sponsored by:
ENTRY FORM Must be Postmarked by
April 17, 2009
Title of video: _______________________________________________ Length: ____: ____
(Up to 5:00 including credits)
Student producer’s name as it would appear on an award: _____________________________________________________ (If more than one student producer’s name is to appear on an award, please list their name(s) and information on a separate sheet)
Grade: ______ Age: _______ Address: ________________________________________________________________________ City: _____________________________ State: ________ Zip Code: _______________________ Phone: ___________________________ Email:_________________________________________ Name School/Organization: _________________________________________________________ Address: __________________________City: ____________ State: _____ Zip Code: _________ Teacher/Sponsor: (please print first & last name) ___________________________________________ Phone: (Work)_____________________________ (Home or cell) __________________________ Email: ____________________________________ Signature: _____________________________ CHECK THE ONE TOPIC THAT BEST REFLECTS THE THEME OF YOUR PRODUCTION Advertising
Heroes
Alcohol, tobacco and other drugs
Love/Relationships
Body Image
Media
Cultural Identity
Politics
Education
Racism
Environment
Stereotyping
Global/Social Issues
Violence
Health
Other? (explain in statement)
IMPORTANT - PLEASE CHECK OFF THAT YOU HAVE COMPLETED AND ENCLOSED EVERYTHING YOU NEED. SEE FESTIVAL GUIDELINES FOR ANY ITEM YOU DON’T UNDERSTAND.
___ ___ ___ ___ ___ ___
My/our entry is on a DVD-R format disc playable in a home DVD player. The disc is labeled on the top in Sharpie with title, my name, and phone number. A statement (up to 100 words) about my/our video is on the back of this form. The soundtrack is original? (Original soundtracks will receive extra consideration). A Permission/Release form for EACH student producer is included. My entry is appropriate as described in the Festival Guidelines.
• • •
Mail entries to JENNIFER SLACK, 3723 19TH AVE SW, SEATTLE, WA 98106 All DVDs become the property of Action for Media Education FIND COPIES OF ENTRY AND PERMISSION FORMS AT THE AME WEBSITE: http://www.action4mediaeducation.org/projects.html Sponsored by:
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