Professional Documents
Culture Documents
Form Short Film Competition
Form Short Film Competition
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Pernahkah film ini dikompetisikan di festival film lain / Has this movie been competed
in any other film festival ?
Ya /Yes ( ) Sebutkan nama festival film dan tahunnya / Please State the film festival
and year of competition
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Tidak / No ( )
3. FILM CREDIT
Sutradara /
Director:______________________________________________________________________
Produser / Producer:
______________________________________________________________________
Penulis Naskah/ Scriptwriter:
_______________________________________________________________
Director of Photography (DOP):
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Pemeran / Cast:
__________________________________________________________________________
Penyunting/ Editor:
_______________________________________________________________________
Pengarah Artistic/ Art Director:
______________________________________________________________
Penata Musik/ Music Arranger:
______________________________________________________________
Lainnya/ Others:
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Biografi singkat sutradara (tidak lebih dari 30 kata) / Directors short biography (not
more than 30
words)_________________________________________________________________________________
_
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Pernahkah sutradara memenangkan penghargaan/ Has the Director won an award?
Ya/ Yes (
) Sebutkan nama penghargaan dan tahunnya/ Please state what award and
year of receiving
_______________________________________________________________________________________
_Tidak / No (
35mm ( )
16mm ( )
Mini DV ( )
Digital (
)
Format lain / Other format: _________________________________________________________________
Rasio aspek / Aspect ratio: 1.33 ( ) 1.37 ( )
1.66 ( )
1.85 ( )
2.35 ( )
2.39 (
)
Lainnya / Other:
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Hitam dan putih / Black and white ( )
Berwarna / Color ( )
Suara / Sound:
Mono ( )
Stereo ( )
Silent ( )
ENTRY FORM.
( )
FILM (dalam format DVD, file dalam flash disk, external hard disk, atau link/URL
termasuk password untuk video streaming) / FILM (in a format of DVD, file in
flash disk or external hard disk, or link/URL including password for video
streaming).
( )
STILL IMAGE FILM (FOTO ADEGAN) DAN FOTO SUTRADARA (masing-masing dalam
format JPEG, high-res 300dpi) dalam format CD, file dalam flash disk, external
hard disk, atau file transfer via email / STILLS FROM FILM AND DIRECTORS HEAD
SHOT (each in the format of JPEG, high-res 300dpi) in CD format, file inside of
flash disk or external hard disk or file transfer via email.
dan saya/kami sepenuhnya mengganti kerugian PT Plaza Indonesia Realty, Tbk. selaku
penyelenggara Plaza Indonesia Film Festival terhadap klaim yang dibuat untuk seperti
pelanggaran hukum. / I/We have read all the Plaza Indonesia Film Festival Short Film
Competition rules and guidelines. I/We understand and have
complied with all these rules. I/We warrant the submission of my/our original work and
there are no disputes regarding the ownership of my/our submission. I/We also
warrant the submitted material does not defame or invade the rights of any person
living or dead and I/we fully indemnify PT Plaza Indonesia Realty, Tbk. as the organizer
of Plaza Indonesia Film Festival against any claim made for such violations of law.
Saya / kami dengan ini membebaskan PT Plaza Indonesia Realty, Tbk. selaku
penyelenggara Plaza Indonesia Film Festival dari dan membela mereka terhadap
semua klaim, tuntutan, kerugian, kerusakan, penjurian, kewajiban, dan biaya
(termasuk biaya pengacara) akibat dari atau sehubungan dengan setiap dan semua
klaim pihak ketiga, baik beralasan atau tidak, atas setiap film yang diserahkan kepada
Plaza Indonesia Film Festival./ I/We hereby hold PT Plaza Indonesia Realty, Tbk. as the
organizer of Plaza Indonesia Film Festival harmless from and defend them against all
claims, demands, losses, damages, judgments, liabilities, and expenses (including
attorneys fees) arising out of or in connection with any and all the claims of third
parties, whether or not groundless, based on any film submitted to the Plaza Indonesia
Film Festival.
Saya/kami menyatakan bahwa saya/kami memegang semua rilis yang diperlukan
untuk semua gambar, personil, musik, naskah dan materi yang telah dihakciptakan
lainnya. Saya / kami memahami bahwa semua materi yang disampaikan secara resmi
oleh pembuat film dan/atau produser digunakan dalam tujuan publisitas untuk Plaza
Indonesia Film Festival, dan bahwa PT Plaza Indonesia Realty, Tbk. selaku
penyelenggara Plaza Indonesia Film Festival memiliki hak untuk menggunakan salah
satu atau semua materi untuk penggunaan non-komersial (publisitas, promosi dan
grafis). Modifikasi atau pengabaian salah satu ketentuan formulir ini harus dilakukan
secara tertulis dan ditandatangani oleh saya / kami dan perwakilan dari PT Plaza
Indonesia Realty, Tbk. selaku penyelenggara Plaza Indonesia Film Festival.
I/We declare that I/we hold all necessary releases for all images, personnel, music,
script and any other previously copyrighted material. I/We understand that all
submitted materials are authorized by the filmmaker and/or producer for use in
publicity purposes for the Plaza Indonesia Film Festival, and that PT Plaza Indonesia
Realty, Tbk. as the organizer of Plaza Indonesia Film Festival has the right to use any
or all of these materials for non-commercial use (publicity, promotion and graphics).
Modification or waiver of any of the provisions of this form must be in writing and
singed by myself/us and a representative of PT Plaza Indonesia Realty, Tbk. as the
organizer of Plaza Indonesia Film Festiv Pal.
Saya/ kami menyatakan apabila terpilih menjadi pemenang Best Short Plaza Indonesia
Film Festival-Short Film Competition 2016 bersedia untuk memproduksi film pendek
selanjutnya yang akan ditayangkan perdana pada Plaza Indonesia Film Festival 2017./
I/We hereby declare if we are selected as winner of Best Short Best Short Plaza
Indonesia Film Festival-Short Film Competition 2016, agree to produce the next short
film that will be premiered at Plaza Indonesia Film Festival 2017.
Saya / kami dengan ini menjamin bahwa semua pernyataan di sini adalah benar dan
tepat./ I/We hereby warrant that all of the statements herein are true and correct.
Jakarta, ____________________________________ 2015
Nama & Tandatangan / Name & Signature