| 1. *Submission Title |
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| 2. *Entrant (First Name, Family Name) |
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| 3. Entrant Title |
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| 4. *Mailing Address (Street, City, State, Zip Code or Postal Code) |
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| 5. Country |
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| 6. *Telephone |
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| 7. Fax |
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| 8. *Email Address |
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| 9. URL (if available) |
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| 10. *Submission Format |
1/2 " VHS (NTSC, SP Mode)
DVD
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| 11. *Original Production Format |
16mm
BetaSP
VHS
SVHS
Digital Video
Other
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| 12. *Running Time |
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| 13. *Language of the Submission |
Originally in English
Dubbed in English
Subtitled in English
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| 14. *Date of Production |
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| 15. If previously broadcast, provide the Station, City, State and Country where first aired. |
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16. Was this program part of a series?
(Check box if "Yes")
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Yes |
17. *Submission Category
(May choose up to 3) |
One-Minute Video (suubmit at YouTube)
Chocolate Television
General Cooking Demonstration
Food & Romance, or Food & Fashion
Travel
Desserts
Wine & Beverages
Short Film or Documentary
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| 18. *I Agree to the Terms and Conditions of the INDIE FOOD CHANNEL Competition & Film Festival 2006 and have read the TERMS page |
Check box if Agree / Uncheck if Disagree |
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19. I heard about the INDIE FOOD CHANNEL Competition & Film Festival 2006 from:
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Newspaper
Magazine
Film/Video website
Film School
Organization
Friend / associates
Film Festival Website or Publication
Food Journalist
Search Engines
TCB-Cafe Publishing
Cable Access
Other
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| 20. Next Step: Be sure to PRINT this form, SIGN it, and INCLUDE in your mailed competition materials. After printing the form, press the SUBMIT button below to proceed to the secure credit card payment area. After submitting online the 2006 Entry Form, you will be directed to a web page to pay your entry fees online. The preferred method of secure credit card payment is via PayPal. |
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| 21. *YOUR SIGNATURE HERE (Print first, then sign and date): |
_______________________________________
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| 22. * |
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