Black Maria Film Festival Online Entry Form
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Title:
Date Completed:
Running Time: minutes

Director:
First Name:
Last Name:

Producer or Representative:

Street:
City:
State:
Zip:
Country:

Day Tele No.:
Evening Tele No.:

Email:

Entry Format:
VHS
DVD
16MM

Exhibit Format:
VHS
DVD
Mini DV
Beta SP
16MM
35MM