The Young Media Makers
Big Screen Showcase Entry Form
http://www.theyoungmediamakers.org

Sponsored by the North Coast Cultural Trust and the North Coast Communities Advancing the Arts, Barbara A. Domanchuk Media, The Vision Center in Eureka, Copia Group and Creativity Floats

Download and sign the Permission for Media Release Form (DOC RTF). Then fill in the fields below, select print on your browser, and after the form prints, click the 'Submit' button. You must label your media entry with your name, movie title, category, and length and mail it with the two forms to: Big Screen Showcase, PO Box 204, Carlotta, CA 95528

Filmmaker's name
Filmmaker's age
Movie title
Category Other:
Length
Phone
Email
Web
Contact name (first and last name over 21 yrs)
School, Organization, or Sponsor (over 21 yrs)
Address of School or Sponsor (Street, City, State)
Zip code
Short biography (max 20 words)