2010 Archival Screening Night Submission Form Survey

The AMIA Archival Screening Night provides conference participants with an opportunity to showcase recent acquisitions and preservation efforts.

Conference participants interested in submitting material for screening should complete this form no later than October 10, 2010. Screening Night participants will be contacted after this date to confirm their participation.

If you are showing material as part of any other screening or panel during the conference, we ask you not to submit that piece to the Screening Night. Due to the increasing length of Screening Night, it is possible that not all pieces submitted will be included in the program.

Your Contact Information(Required.)

Name:

Company:

Address 1:

City/Town:

State/Province:

ZIP/Postal Code:

Country:

Email Address:

Phone Number:

Name of the presenter on screening night(Required.)

Please note that we will try to accommodate as many formats as possible within the facility's limits.

Film or Video?(Required.)

Film

Video

Format
If you are requesting 35mm or 16mm, please also tick the boxes for any other formats that you can provide the material in, should we be unable to screen your film format. If you can only supply a film print, please state this in the 'Other' section below.(Required.)

Other (please specify)

Duration(Required.)

Sound or Silent?(Required.)

Sound

Silent

Aspect ratio (film and video)_________(Required.)

Please briefly describe your submission as you would like it to appear in the screening night brochure (50 words or less). Also indicate whether or not the material you submit may be offensive to others or graphic in content. (Required.)

Comments, other information?

Deadline is October 10, 2010.
More information available at www.AMIAConference.com