The Takoma ParkSilver Spring Experimental Film Festival Official by oqp13905


									                                                              The Takoma Park/Silver Spring Experimental Film Festival
                                                                             Official Entry Form

                                        Deadline: April 2, 2010

                                        There is no entry fee.

                                        Entries accepted by mail or by hand:
                                        C/O Pyramid Atlantic Arts Center, 8230 Georgia Avenue, Silver Spring, MD 20910
                                        (Enclose a stamped self-addressed postcard for acknowledgement of receipt of submission and a
                                        SASE for return of submission materials. No metered postage please).
                                        -------------------------------------------------------------------------------------------------------------- --------
                                        Title of work: _______________________________________________________

                                        Running time: _________                    Year produced: _______


                                        ____Experimental Narrative ____Experimental Documentary
                                        ____Experimental Animation ____Just Plain Old Experimental ___Video Art
                                        ____Landscape Films ___Poetic Text Films
                                        _____Other (specify): ___________________________

                                        Is this a premiere? _____No _____ World Premiere _____ US Premiere ____ MD Premiere
BOARD OF DIRECTORS                      If no, please list where the work has previously screened: __________________________
Amy Kincaid, Chair
Beverly Denbo
Yolanda Branche                         Formats available for festival screening: ____DVD ___VHS ___other (specify) _______
Richard Dana
Jenny Freestone
The Honorable Sheila Hixson             Note: For festival screenings, we strongly prefer DVD copies.
Omar Karim
Bobbi Kittner
Jennifer Nettles
                                        Submitter's Name: ___________________________________________________________
Dr. Michael Pollack
Kimberly Rattley                        Relationship to Production: ____________________________________________________
Shirley Sagawa
John Sparico
Sally Sternbach                         Address: ___________________________________________________________________

STAFF                                   Country: ____________________________________________________________________
Jose Dominguez
Executive Director
                                        Phone: __________________ (day) ___________________ (evening)
Gretchen Schermerhorn
Director of the Paper Mill,             __________________ (cell) Email address: _______________________________________
Collaborative Art Projects & Outreach

Matthew Sole                            Are you a student? ____Y ____N. If yes, specify grade level or college level: ____________
Director of Business Development

Catherine Aselford                      The Takoma Park/Silver Spring Experimental Film Festival showcases work relevant to the diverse
Development Manager                     and socially progressive Takoma Park and Silver Spring communities. Its programming committee is
Richard Kamenitzer                      interested in innovative and experimental work and work on topical themes. Briefly describe why
Executive Consultant                    your film or video will be of interest to our audience.
Helen C. Frederick
Director Emeritus                       _________________________________________________________________________________
8230 Georgia Avenue
Silver Spring, MD 20910                 Film Synopsis (50 words or less)
Phone: (301) 608-9101                   _________________________________________________________________________________
Fax: (301) 608-9102
email:        _________________________________________________________________________________        _________________________________________________________________________________
                                        I certify that I am the owner of the film/video I am submitting or own the theatrical rights, or can
                                        acquire written permission to screen the film/video, and I indemnify the festival collectively and
                                        individually against any and all claims regarding the film/video. I hold the festival harmless from
                                        accidental damage or loss of materials submitted.
                                        Signature (if minor, parent's signature) _____________________________
                                        Date: ___________

                                        For questions please email Jose Dominguez at or call 301-646-

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