SCHEDA D ISCRIZIONE / ENTRY FORM

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1 - 1ª edizione / 1 th edition Festival internazionale di cinema e ambiente/ International Festival of environmental cinema (Palermo, 27 Maggio May, 27 / 1 Giugno 2005 June, 1 th. 2005) SCHEDA D ISCRIZIONE / ENTRY FORM Si prega di compilare la scheda d iscrizione in stampatello ed inviarla al seguente indirizzo entro e non oltre il 3 Maggio 2005 (farà fede il timbro postale) / Please write in capital letters and mail to the following address by May, 3 rd 2005 : c/o DoC Via Francesco Bentivegna, PALERMO ITALY 1. Indicare la sezione alla quale si intende iscrivere l opera / Choose the competition: o Ambientale sociologica / Environmental - sociological o Eco-turistica / Eco-tourist o Panorama o Eco Scuola / Eco School 2. INFORMAZIONI SULL OPERA / FILM S INFORMATIONS Titolo originale / Original title Titolo tradotto in inglese / English title Anno di produzione / Year of pruduction Paese di produzione / Country of production Durata / Running time Formato originale / Original format o 16 mm o 35 mm o Betacam SP o DVC Pro 25 o DV Cam o Mini DV

2 (tutti esclusivamente in formato PAL / only in PAL format) Colore / Colour Bianco e nero / Black & white Lingua originale / Original language Lingua dei sottotitoli / Language of subtitles 3. CARATTERISTICHE TECNICHE / TECHNICAL CHARACTERISTICS Supporto inviato per la selezione / Format for the selection: VHS PAL DVD PAL Altro / Other Formato per la proiezione al Festival / Festival Screening Format: PELLICOLA / FILM 35 mm 16 mm Metraggio / Lenght:. Numeri di bobine / Number of reels:. Suono / Sound: muto / mute mono magnetico / magnetic dolby ottico / optical stereo VIDEO Betacam SP DVC Pro 25 DV Cam Mini DV DVD (tutti esclusivamente in formato PAL / only in PAL format) 4. CREDITS Regista / Director: Sceneggiatura / Script: Fotografia / Photography:

3 Montaggio / Editing: Musica / Music: Suono / Sound: Animazione / Animation: Interpreti / Cast: Produzione / Production: Distribuzione / Distribution: 5. CONTATTI / CONTACTS Regista / Director: Indirizzo / Address: Telefono / Phone: Cellulare / Mobile: Fax: Produzione / Production: Contatto / Contact: Indirizzo / Address: Telefono / Phone: .. Fax:... Distribuzione / Distribution:

4 Contatto / Contact: Indirizzo / Address: Telefono / Phone: . Fax:.. 6. ALTRO MATERIALE INFORMATIVO / OTHER INFORMATIVE MATERIAL Sinossi del film / Synopsis of the film:. Biografia del regista / Director s biography:. Filmografia / Filmography: Festival ai quali è stato presentato / Screening at:. Premi / Awards:. Proprietario dei diritti / Copyright owner

5 Il proprietario dei diritti autorizza la messa in onda di alcuni estratti del film (3 minuti circa)? / The copyright owner permits the use of clips from the film (about 3 minutes)? 7. DOCUMENTAZIONE DA INVIARE PER LA SELEZIONE / DOCUMENTATION FOR THE SELECTION VHS o DVD in formato PAL / VHS or DVD copy in PAL format Biofilmografia del regista / Director s biofilmography N. 3 foto del film + n. 1 foto del regista / 3 stills from the films + 1 still of the director Dichiarazione del regista riguardo il film / Director statement about the film Lista dei dialoghi e testo dei sottotitoli (se previsti) / Dialogue s list and subtitles (if present) Lista dei Festival ai quali il film ha partecipato precedentemente ed eventuali premi vinti / Previous Festivals the film has been in and prizes won SE SELEZIONATI / IF SELECTED: Locandina del film / Movie poster Rassegna stampa / Press booklet Estratti del film di circa 3 minuti / Trailer of the film (about 3 minutes) N. B. La documentazione rimarrà a far parte dell archivio del Festival / The documentation will stay in the Festival s archive L iscrizione al Festival implica l accettazione del regolamento / Participation in this Festival implies the acceptance of its regulations. Nome / Name. Data / Date Firma / Signature. TERMINE ULTIMO PER LE ISCRIZIONI: 3 MAGGIO 2005 DEADLINE FOR ENTRIES: MAY, 3 RD 2005 c/o DoC Via Francesco Bentivegna, PALERMO Tel Fax dottobre@oasi.net Web:

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