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The Ursula Awards Film Festival 2013
Submission Form - Deadline for submissions: Thursday, August 1, 2013 by 5:00 PM
SUBMISSION PACKAGE CHECKLIST
Two DVD Preview Screener Copies labeled with Title, Duration, Name, Address, and Phone Number of
submitter. Preview copy must be submitted on DVD. Both PAL and NTSC systems are accepted. DVD Preview
copies will be retained by the festival. We do not return DVD screeners.
Paid Entry Fee for each submission. $25 per submission
$10 per submission
All payments must be in US Dollars, or be drawn on a bank in the USA.
Checks and Money Orders must be made payable to: Vallejo Community Access Television
Mailing address: 55 Springstowne Ctr. #150, Vallejo, CA 94591
Entry fees are not refundable.
Applicant Information
Name: __________________________________________________________________________________
Address: ________________________________________________________________________________
City: ___________________________________________ State: ____________ Zip: __________________
Email: __________________________________ Phone Number: _________________________________
If Student, Name of School: _______________________________________________________________
Student ID#: _____________________________________________________ Age: __________________
Short Bio about yourself:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Film Information
Title: _________________________________________________________________________________
Run-Time: __________________
Your Creative Role(s): __________________________________________________________________
Director: __________________________________________________________________
Writer: ____________________________________________________________________
Producer: _________________________________________________________________
Cinematographer: __________________________________________________________
Sound: ___________________________________________________________________
Music: ____________________________________________________________________
Principle Cast:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Brief Synopsis of Film: (If you need more room, please attach an additional page)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Date Completed: _______________________________
Language: ________________________ (If not English, must have English subtitles)
Category: (circle one)
Short Film
Feature
Documentary
Spiritual/Religious
Political
Community
Sports
Arts
Entertainment
PSA
Educational
Lifestyle
Children/Youth
Disclaimer
I understand that submission of my work authorizes Vallejo Community Access Television to use the work for
exhibition, education, and/or publicity purposes. VCAT will handle the prints, tapes, and accompanying PR and
supporting materials with the maximum of care but cannot be held liable for any damages or loss during
shipping, use, preview, or screening; and that VCAT is also not responsible for any claim involving copyright,
trademark, credits, or royalty infringement related to the work.
Print Name: _______________________________________________________________
Signature: _____________________________________ Date: ______________________
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