CSU MEDIA ARTS FESTIVAL ENTRY FORM *NOTE – Information for EACH student and the advisor MUST be complete in order for submission to be accepted. All parties must sign below. Only students listed on this form will be recognized as entrants and candidates for awards and prizes. NAME OF STUDENT #1 SUBMITTING ENTRY: Creator First Name Director Producer Writer Last Name Mailing Address Email Phone Campus Department Current Student Status: Freshman Most Recent Enrollment: Summer 2014 Sophomore Fall 2014 NAME OF STUDENT #2 SUBMITTING ENTRY: Junior Senior Grad Student Graduation Date Spring 2015 Creator First Name Director Producer Writer Last Name Mailing Address Email Phone Campus Department Current Student Status: Freshman Most Recent Enrollment: Summer 2014 Sophomore Fall 2014 Junior Senior Grad Student Graduation Date Spring 2015 FACULTY ADVISOR INFORMATION Advisor Name Advisor Department Advisor Phone Advisor Email ENTRY INFORMATION Title: Date of Completion: Total Running Time: Format: HOURS MINUTES SECONDS Brief Description of Project/Piece: 1 Student's Name QuickTime MP4 PDF (Screenplay) Select Category: Choose Only One Animation Music Video Promotional Television, Episodic Documentary Narrative Screenplay, Feature Television, News Experimental New/Interactive Media Screenplay, Short Television, Variety Motion Design All submissions, except screenplay, must have a moving image component. Would you like to receive scores and comments after the festival? Yes No Please read the following and indicate your agreement with your signature(s) below: a. If my work is selected for the CSU Media Arts Festival, I grant permission to modify the work so as to facilitate the screening of the work at the festival in Fall 2015, and at any other CSU-related screenings. b. I grant permission for my work to be copied, reproduced, displayed, used, and/or broadcast at any or all CSU campuses for educational purposes. c. I understand that the CSU Media Arts Festival cannot accept responsibility for lost or damaged materials. d. I own or have rights to all literary, artistic, musical and intellectual property rights within the work. e. I agree to indemnify and hold harmless the State of California, Board of Trustees of the California State University, and their respective officers, agents and employees, as well as the CSU Media Arts Festival against all claims or losses, including against all claims of copyright infringement, relating to or resulting from the rights granted herein. f. I agree to the terms and rules of the CSU Media Arts Festival as stated above and warrant that, to my knowledge, all the information is correct. ENTRANT #1 SIGNATURE DATE ENTRANT #2 SIGNATURE DATE FACULTY ADVISOR SIGNATURE DATE SUBMIT: 1. Each project/piece must have a complete and separate signed ENTRY FORM. 2. Entrants may submit multiple projects on a single CD, DVD or USB drive, as long as submissions are clearly labeled by category and project. 3. $15 entry fee per submitted project (NOT per media format). Check or money order payable to CSU Media Arts Festival. We are unable to accept credit cards, debit cards, or electronic payments at this time. DO NOT send cash. If submitting multiple entries, entrant may submit one check or money order for all entries. Indicate entry names in the memo section. 4. MAIL: Entry Form, Payment, and Media to: CSU Media Arts Festival, Office of the Chancellor 401 Golden Shore, 2nd Floor, Long Beach, CA 90802-4210 2 Student's Name
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