2002 International Surrealist Film Festival
Official Submission Form
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english language title ________________________________________
original language title _______________________________________
country(ies) of production ____________________________________
original language(s) __________________________________________
running time __________________________________________________
date completed ________________________________________________
original format _______________________________________________
aspect ratio:
_ 1:33
_ 1:66
_ 1:85
_ 2:35 (scope)
optical sound format:
_ mono
_ Dolby A
_ Dolby SR
_ Dolby Digital
_ other _______________________________________________
submission fee:
_ $35
_ $30 + uncut photobooth picture
method of payment:
_ check
_ money order
principal contact information:
name __________________________________________________
position with film or music video _____________________
address _______________________________________________
city ____________________ state ____ zip ____________
day phone _________________ eve phone ________________
fax ________________ e-mail __________________________
director:
name __________________________________________________
address _______________________________________________
city ____________________ state ____ zip ____________
day phone _________________ eve phone ________________
fax ________________ e-mail __________________________
writer:
name __________________________________________________
address _______________________________________________
city ____________________ state ____ zip ____________
day phone _________________ eve phone ________________
fax ________________ e-mail __________________________
producer:
name __________________________________________________
address _______________________________________________
city ____________________ state ____ zip ____________
day phone _________________ eve phone ________________
fax ________________ e-mail __________________________
additional credits:
camera ________________________________________________
editor ________________________________________________
principal cast ________________________________________
_______________________________________________________
artist (music video only) _____________________________
label (music video only) ______________________________
screening history:
screenings in US and abroad (including festivals) _____
_______________________________________________________
_______________________________________________________
television presentations (outside of US) ______________
_______________________________________________________
_______________________________________________________
prizes or awards ______________________________________
_______________________________________________________
representation (if applicable):
world sales representative ____________________________
telephone ___________________ fax ____________________
email _________________________________________________
U.S. sales representative _____________________________
telephone ___________________ fax ____________________
email _________________________________________________
How did you hear about the International Surrealist Film Festival?
_______________________________________________________
_______________________________________________________
release:
I, the undersigned, acknowledge and agree as follows:
_ I have read, understood and complied with all eligibility requirements.
_ To the best of my knowledge, all of the statements in this document
are true.
_ This film is not subject to litigation and is not threatened by any
litigations.
_ I hold the International Surrealist Film Festival harmless from
damage to or loss of the print en route to the Festival.
_ I am duly authorized to submit this film to the Festival.
signature: date: