Anime Evolution 2010 ANIME MUSIC VIDEO CONTEST SUBMMISSON FORM Submission Name/Studio (to appear in credits): Real Name (video creator(s)): Mailing Address: Phone #: E-mail Address: ENTRY#1: Video Title: Music/Song Title and Artist: Source Footage (if more then 3, enter various): Best fit Category (select one and two alternates by preference using the numbers 1-3): ___ Drama - Romance ___ Drama - Sentimental ___ Drama - Serious ___ Action ___ Horror ___ Upbeat - Dance ___ Comedy ___ Parody ___ Trailer ___ Fun ENTRY#2: Video Title: Music/Song Title and Artist: Source Footage (if more then 3, enter various): Best fit Category (select one and two alternates by preference using the numbers 1-3): ___ Drama - Romance ___ Drama - Sentimental ___ Drama - Serious ___ Action ___ Horror ___ Upbeat - Dance ___ Comedy ___ Parody ___ Trailer ___ Fun Authorization: By submitting my entry along with a filled out copy of this form, I hereby certify that all the above information is correct and the music video entries submitted is the creations/own work of the video creator as named on this form. I grant AnimeEvolution 2010 permission to display my entry as they see fit.