Smogdance Entry Form

    SMOGDANCE - 2009 ENTRY FORM

Or print out form and send it along with your entry fee and film to:

    dA Center for the Arts
    252-D So. Main Street
    Pomona, CA 91767

Name:

Street Address:

City,State,Zip:

Email:                                          Phone:

Title of Entry:

Entry category:                                                       Student? YES    NO

If YES, school of attendance:

Date completed:

Brief description of why your entry fits this category:








Total running time:

Original Format film video audio:

I agree to the terms and conditions of Smogdance 2009:

Filmmaker:

Date: