INSTRUCTIONS: Please fill in all entry information requested below in legible block letters or typed letters.

The 20th Tokyo Video Festival Entry Form

Composition(No limitations)
[ ]General
[ ]Art-inspired
only for sponsor's use

Tape No.
[ ]Individual
[ ] Group
Date:
Month __ Day __ Year __
[ ]Please return the video tape submitted

[ ]Please do not return the video tape submitted

Title

Name(group representative)
Sex:
[ ] male
[ ] female
The undersigned verifies that all information contained herein is correct,and that he/she or the group he/she represents is solely responsible for the contents of the submitted video and has all rights to it,and if it receives an award at the 19th Tokyo Video Festival,authorizes the sponsor to make copies of,exhibit,screen,distribute,broadcast or re-broadcast by cable or air waves for non-commercial and promotional purposes.
Signature 　 　 　 　 　 　 　 Age 　 　 　 　 Date of birth 　 　 　 　 Occupation

Group Name
Present Address (Country)
Telephone No.
Business/School Address (Country)
Telephone No.

Video composition submitted

Length: __ minutes __ seconds
Language (                )
 
Audio: [  ] stereo  [  ] monaural 

       [  ] hi-fi   [  ] normal  

       [  ] without audio [  ] others (         )

Color broadcasting system

 
[  ] NTSC   [  ] PAL   [  ] SECAM   [  ]high-band
  
 Video: [  ]color   [  ]black&white

Video camera used

 
Brand Name               Model No.

VTR/VCR used

 
Brand Name               Model No.

Number of years that you have used a VTR: ____years _______months

How did you know about this Festival?

[ ] JVC Home page [ ] Poster(Place: ) [ ] Magazine (______ )[ ]Other( ______)

*Please write on a separate sheet the content of the work and points you particularly wish to emphasize.
*If you need additional space,please attach another sheet of paper.
*Glue the completed entry form onto the tape-protective case to be sbmitted.