THE 2009 INDIE SHORT FILM COMPETITION ENTRY FORM
MAIL ALL ENTRIES TO: Indie Short Film
Competition PO BOX 1185 Fort Lauderdale, FL 33302 U.S.A.
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EACH ENTRY MUST INCLUDE:
1.) A completed Entry Form with an original signature.
2.) Short
Film on DVD or VHS only, regardless of original shooting format. 1 to 40 minutes in
length. * Entries must be NTSC format only. PAL is NOT accepted. * Foriegn DVD's must be formatted
for Region Code 1 (North America) or Region Code 0
(Universal).
3.) Entry Fee (US Currency Only) (US Currency Only)
ENTRY DEADLINE: Entries must be
postmarked no later than December 15, 2009!
PLEASE PRINT CLEARLY
NAME: ________________________________________________________________________________
ADDRESS: ____________________________________________________________________________
CITY: _______________________________________
STATE / PROVIDENCE: ____________________
ZIP / POSTAL CODE: __________________________ COUNTRY: _______________________________
PHONE NUMBER: _____________________________ EMAIL: __________________________________
Title of Short Film
/ Video: (In English if Foreign entry) ______________________________________________
Total
running time: (including front and back credits) _________________________________________________
Check ONE category only o Comedy o Horror / Thriller o Drama o Action / Adventure
o Animation
o Family
/ Children o Sci-Fi o Documentary
o LGBT o Music Video
Please write a short synopsis of your story. (Please print clearly - attach to entry
form if more room is needed.) _______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Director(s): _____________________________________________________________________________
Producer(s):
____________________________________________________________________________
Writer(s): ______________________________________________________________________________
Company Name: (if applicable) _____________________________________________________________
How did you hear about the Indie Short Film Competition: ________________________________________
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ENTRY FEES - You Must Check One Box Early
Entry Deadline - Entries postmarked by September 15, 2009 or earlier!
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o
Under 20 Minutes: $40.00
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o 21 to 40 Minutes: $55.00
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Regular Entry Deadline - Entries postmarked
by November 15, 2009 or earlier!
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o
Under 20 Minutes: $45.00
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o 21 to 40 Minutes: $60.00
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Final Entry Deadline - Entries postmarked
by December 15, 2009 or earlier!
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o
Under 20 Minutes: $50.00
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o 21 to 40 Minutes: $65.00
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Select a method
of payment: o CHECK / MONEY ORDER o
VISA o MASTERCARD
Make your check or money order payable
to: Indie Short Film Competition Payment from countries outside the U.S.A. must be in the form of a U.S. Bank Check,
money order, cash, or credit card. IF PAYING BUY
CREDIT CARD
Card number: ____________________________________________
Expiration Date: _________________
Name on card: __________________________________________________________________________
Complete Billing Address: _________________________________________________________________
Cardholder
Signature: ____________________________________________________________________
I certify that I have read, understood and accept the Indie Short Film Competition rules & regulations as they appear on the competition website.
Entrant's Signature:
_______________________________________________ Date: _________________ If the entrant is under 18 years old, the signature
of the parent or gaurdian is required.
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