PLEASE SEND THIS FORM BY EMAIL ALONG WITH A

PROPOSED VIDEO:

Title:

Title in English:

Duration:

Country of production:

Year of production:

Previous screenings:

Awards, distinctions:

Genre:

(e.g. video art, animation, experimental video, short movie etc.)

Special showcase:

(if you are applying for one of the theme programs scheduled for 2011)

Synopsis

(fill in or enclose extra sheet)

Link for download

(only if you choose to send your video via the net)

Video format: Please notice: Preferably PAL copies. Do not send masters.

Production format:

miniDV

VHS

S-VHS

Hi8

BETACAM

Other (specify):

Presentation format:

DVD

Movie file: .avi

Movie file: .mov

Sound:

stereo

mono

silent

Colour:

colour

black & white

Original language:

Subtitles:

AUTHOR, ARTIST, DIRECTOR (if group, indicate the name of the group):

Last name:

First name:

Year of birth:

Sex:

Country:

Address:

Phone(s):

Fax:

e-mail:

Website(s):

CV (short biography, screenings and exhibitions) fill in or enclose extra sheet

Credits:

Director:

Script:

Photography:

Music:

Camera:

Editing:

Animation:

Effects:

Sound editing:

Actors:

Production:

Distribution:

Additional information:

COPYRIGHT:

Do you permit (indicate yes or no):

• the distribution of your video for participation in other events (after notice, but without any additional signed permission)?

YES

NO

• forward of your e-mail address to other festivals, persons or organizations that might be interested in your work?

YES

NO

I state that I'm the owner of the rights of the submitted video. By filling and sending this application form, I accept the entry regulations of the festival and I permit:

• the free presentation of my video in the context of Festival Miden 2011 and in future screenings, presentations and events organized, co-organized or curated by Festival Miden

• TV broadcast of the submitted video for promotional purposes

• presentation of my video on the festival website www.festivalmiden.gr

• publication of video stills extracted from my video in festival catalogues, booklets, the festival website and press media

• publication of the texts enclosed to the proposal (cv, synopsis, etc.)

• archival, non-profit usage of my video by the festival

Name(s):

Address:

Phone(s):

fax:

e-mail:

I assure that the information in this form is correct and I accept the terms and regulations of the festival.

Date:

Signature: