Short Film Contest

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First Name: Last Name: Email: Confirm email address :

Birth Date: (mm dd yyyy)

Gender: Street Address Line 1: Street Address Line 2: City: State: Zip Code: Home Phone: (xxx-xxx-xxxx) Cell Number: (xxx-xxx-xxxx)

Entry Title:

Entry Duration: (mm ss)

Category: Media Format: School Affiliation: Brief Synopsis: (250-500 Word Limit)

I have read the Contest Rules and Regulations .

Ovation TV