EmailMe Form - Florida Entertainment Summit 2011 Film Submission

Name *

Prefix First Last Suffix

Business Name *

Type Of Business

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Email *

Business *

### - ### - ####

Cell *

### - ### - ####

Film Information

Provide Us With Information About Your Film

Title of Project *

Name of Producer(s) *

Director *

Production Company (If Applicable) *

Screen Writer(s) *

If your film is selected by the Florida Entertainment Summit, would this be a: *

World Premiere

North American Premiere

U.S. Premiere

South Florida Premiere

Film School/College (If Applicable)

Budget In Us Dollars *

Under $50,000

Under $250,000

Under $500,000

Over $1 Million

Genre *

Subject *

Shooting Format *

Projected In *

Length *

Running Time

Do you have an agent, and/or manager? (If Yes, Please Provide Names)

Provide a short synopsis, biography of director, cast list, credits and film festival activity: *

Registration Confirmation #: *

Code Given During Your FESummit.Eventbrite.com Registration

I have read and agree to the Terms of Service *

Yes, I agree.

ONLY Electronic Forms Accepted
Call 305‐851‐5699 to confirm late registration options

One registration form per registrant

Confirmation of film acceptance will be emailed to the email address provided on
Wednesday, November 30, 2011. Phone calls will be made to registrants without email addresses

Advance registration MUST be time stamped cut off date:
$25 on or before October 31, 2011
$40 on or after November 1, 2011

Thank you for registering for the 2011 Florida Entertainment Summit Cinema Lounge

www.FloridaEntertainmentSummit.com