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REGISTRATION FORM (SEANEMA/SHORT DOCUMENTARY FILM COMPETITION)

Instructions: Individual participants can directly fill out this form. For group participants, kindly identify the leader to fill out this form. As for the rest of the members of the group, the names can be written at the back of the registration form. In case of group winners, the team leader shall represent the group to receive the award during the Awarding Ceremony in Quezon City.

Last Name

First Name

Middle Name

Complete Home Address

E-Mail Address

Contact Number(s)

Date of Birth

Name of University/College

University/College Address

Year Level and Course

Dean's Name

Title of the Documentary Film

Brief Description of the Documentary Film

I attest that the information above are true and correct, and that any false information written above can be used as grounds for my disqualification from the contest. __________________________________ Contestant's Signature over Printed Name __________________________________ Date Signed __________________________________ Dean's Signature over Printed Name __________________________________ Date Signed