Entry Form

Please print and fill out the following entry form. Please mail your completed entry form, including the signed release, and entry fee to:

Name:

Title of Screenplay:

Address:

Phone:

Email:

Professional Experiences:

How did you hear about this contest?

I have read and understood the guidelines as described. I have enclosed my non-refundable $45 entry fee to submit the above titled screenplay.

Signature:

Date: