AnimeNEXT 2012 Anime Music Video Contest Entry Form
Please fill out this form in its entirety, printing clearly.

Your Real Name: __________________________________________________________________

Your E-mail Address:	_______________________________________________________________________

Will you be attending AnimeNEXT 2012? (Not required to enter): ______________________________

Your Mailing Address (for shipping prizes):  	__________________________________________________

						__________________________________________________

						__________________________________________________

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First Entry

Video Title: ________________________________________________________________________________

Length of video: _______________	Approximate date of completion: ___________________________

If this video is a collaboration, list real
names of all other collaborators here: ________________________________________________________

___________________________________________________________________________________________

Pseudonym/studio name to credit the video to
(or blank to use your real name(s)): __________________________________________________________

Video source(s) (for more than three (3),
please enter "various"): _____________________________________________________________________

___________________________________________________________________________________________

Audio source(s) (for more than three (3),
please enter "various"): _____________________________________________________________________

___________________________________________________________________________________________

Please select two to four (2-4) thematic elements present in your video, for categorization purposes
(unless you wish this video to be entered as noncompeting, in which case please mark as such):

____ Action		____ Artistic			____ Character Profile	____ Comedy
____ Dance		____ Dramatic/Serious	____ Fun			____ Horror
____ Romance		____ Segmented/"Hell"-style	____ Sentimental		____ Trailer/Parody
____ Uplifting				____ None -- Noncompeting only

Second Entry (or if you are only entering one video, then leave this whole section blank)

Video Title: ________________________________________________________________________________

Length of video: _______________	Approximate date of completion: ___________________________

If this video is a collaboration, list real
names of all other collaborators here: ________________________________________________________

___________________________________________________________________________________________

Pseudonym/studio name to credit the video to
(or blank to use your real name(s)): __________________________________________________________

Video source(s) (for more than three (3),
please enter "various"): _____________________________________________________________________

___________________________________________________________________________________________

Audio source(s) (for more than three (3),
please enter "various"): _____________________________________________________________________

___________________________________________________________________________________________

Please select two to four (2-4) thematic elements present in your video, for categorization purposes
(unless you wish this video to be entered as noncompeting, in which case please mark as such):

____ Action		____ Artistic			____ Character Profile	____ Comedy
____ Dance		____ Dramatic/Serious	____ Fun			____ Horror
____ Romance		____ Segmented/"Hell"-style	____ Sentimental		____ Trailer/Parody
____ Uplifting				____ None -- Noncompeting only