Film, Video, Audio, Digital

Entry Form

#_______________

(office use)

Name_____________________________________________

Title of Work_______________________________________

Address____________________________________________

City____________________________State_____Zip_______

Phone#(day)____________________(eve)________________

E-mail:

Running Time______________Completion Date___________

Divisions: Circle One

Student Non-student Distributor

Film and Video (Circle and fill out all that apply):

FILM VIDEO

Original: Original:

16mm 8mm 35mm 3/4" VHS

Format Submitted: Digital Other

Format Submitted:

"Made on Mac" (fill out the following):

Website, if applicable :

Computer used:

Software used :

(Circle one if applying in these divisions)

Audio CD Multimedia Internet Media

Categories: (Circle those that apply)

Animation Narrative Documentary Soundtrack

Feature Experimental Outdoor Website

Drama Commercial

Publicity:

May we broadcast your work locally or on the internet for festival publicity?

Yes No

___________________________________

(signature)

Entry Fees:

Student-- $10 first entry, $8 each additional entry.

Non-Students --$19 first entry, $10 each additional entry.

Distributors --$25 per entry.

All foreign entries add $10 (bank charges)

All checks must be made payable to Courtyard Gallery and Agency

Deadline:

Deadline for Film, Video, Audio, CD Multimedia & Internet Media is April 3, 2006(postmark); Extended Deadline is April 14th with $10 additional fee. All entries must have SASE, labeled pre-paid container or international coupon.