2005 Hometown Video Festival Entry Form

Date Of Entry:

Program Title:

Total Length of Program (in minutes, numeric only):

[Names as they would appear on any award - Maximum 50 characters]

1. Producer Name:
2. Producer Name:
3. Producer Name:

CONTACT INFORMATION - All Correspondence will be sent to this person and address

Last Name:          First Name:         MI:
Organization:
Street Address:
Street Address 2:
City: State: Zip Code:
Country:

Daytime Phone #:   Fax:
Email Address:

PLEASE RETURN THE JUDGING FORMS FOR THIS ENTRY (enter Y or N)

The Hometown Management will make every effort to return judging scores and comments to those who specifically request them. However, due to a variety of circumstances beyond our control, ,the Hometown management cannot guarantee the return of all forms.

Check Only One -
Use Worksheet in Manual to Determine Division
Producer Division:   Standard Category:

OVERALL EXCELLENCE
(TO BE SUBMITTED BY ACCESS ORGANIZATIONS ONLY - PROFESSIONAL DIVISION (SELECT ONE)

Overall Excellence Category:
Overall Excellence Division:  

Entry Fee:         Payment Type:

IMPORTANT: For Charge Payments, please fill out the credit card payment form, Print it and return it with your entries.  Your credit card information will not become a record on this site, nor will it be sent over the internet from your computer.

STANDARD ENTRY: SUPPORT INFORMATION

First Air Date:

City / State where first aired:

Number Of Crew Members:

What was the total budget, if any, for the project (numeric only)? $

Whose equipment / facilities were used?

Describe the production equipment used to produce this program.

Who was your target audience (age, profession, cultural group, etc...)?

Was this program part of a series?

(Enter Y/N)  

If yes, how many episodes have you produced?  

Supplemental Questions: In the space below, please answer the following questions. Judges will review these materials as part of the judging process. Please limit your submission to the number of pages specified.

 

What was the purpose of this program; what did you as the producer wish to accomplish?

How did this program idea evolve?

Describe why this program was important to the community that viewed it?

SUPPORT INFORMATION FORM - OVERALL EXCELLENCE

Please compile support information as directed below. The judges will review the answers you provide to the questions below to learn more about how your center uses its resources to empower institutions and individuals to become speakers and information providers. Please provide all the information requested.

DO NOT SEND BINDERS, FOLDERS OR NOVELTIES.

Name Of Access Organization:
Executive Director / Facility Manager:
Is Your Organization: 
The year this organization began providing access services:
Number of paid staff (full-time equivalent):
Annual Operating Budget: $
Annual Capital Budget: $
Total replacement value of production equipment: $
How Many Channels Do You Program:   Type Of Channels:
Total Hours of first-run, locally produced programming cablecast in the last calendar year:  
Number of individuals who utilized your services in 2004:
Number of organizations or agencies who used your services in 2004:
Population of your service area:
Total number of cable subscribers served:
List cities / municipalities served:

1. 2.
3. 4.
5. 6.

Supplemental Questions:

Please answer the following questions. Judges will review these materials as part of the judging process. Please limit your submission to the number of pages specified.

1. Please provide an overview of your Access Organization - history, structure, services, etc... (two pages max):

2. Please describe your facilities and equipment. (one page max):

3. How did programming created through your facility in 2004 address community needs or concerns? (one page max):

4. Please share 2 success stories about how your organization helped groups or individuals to use community media as an effective communications tool in 2004. Include a description of the project and the outcome that resulted from the program airing on your channels. (two pages max):

5. Please provide a list of groups or agencies for which your organization provided media services or support in 2004. (one page max):

6. Please list the businesses or groups that provide in-kind or financial support for your organization in 2004. (one page max).