IMAGES OF YOUTH 2009 VIDEO FESTIVAL
E
NTRY
F
ORM
Must be Postmarked by
April 17, 2009
Title of video: _______________________________________________ Length: ____: ____
(Up to 5:00 including credits)
Student producer’s name asit would appear on an award: _____________________________________________________
(If more than one student producer’s name is to appear on an award, pleaselist 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: _____________________________
C
HECK
THE
ONE
TOPIC
THAT
BEST
REFLECTS
THE
THEME
OF
YOUR
PRODUCTION
AdvertisingHeroesAlcohol, tobacco and other drugsLove/RelationshipsBody ImageMediaCultural IdentityPoliticsEducationRacismEnvironmentStereotypingGlobal/Social IssuesViolenceHealthOther? (explain in statement)
IMPORTANT
- P
LEASE
CHECK OFF
THAT
YOU
HAVE
C
OMPLETED
AND
E
NCLOSED
EVERYTHING
YOU
NEED
.S
EE
F
ESTIVAL
G
UIDELINES
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
J
ENNIFER
S
LACK
, 3723 19
TH
A
VE
SW, S
EATTLE
, WA 98106
•
All DVDs become the property of Action for Media Education
•
F
IND
COPIES
OF
ENTRY
AND
PERMISSION
FORMS
AT
THE
AME
WEBSITE
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