RPS 19th NATIONAL AUDIO VISUAL CHAMPIONSHIP
Friday 4th, Saturday, 5th and Sunday 6th September 2015
ENTRY FORM
Only one entry per form Please download or photocopy this form for additional entry
AUTHOR
Family Name
First name
First Time Entrant?
Distinctions
Yes/No
Pollock Medal Winner?
Address
Co-Authors
E-mail
Telephone No.
Yes/No
YOUR SEQUENCE
Title
Year of production
Duration
Min
Software Used (‘PTE’,
‘ProShow’ &c.)
Sec
File name on disc (CD/DVD)
Author(s) of Text
Author(s) of Original Photographs (See Rule 6)
Spoken by
If copyright music used, details of IAC licences
AT THE END OF THE CHAMPIONSHIP
Your Entry will be erased from the computer’s hard drive. Select one option:
 I will collect my disc at the end of the Championship.
 Destroy my disc at the end of the Championship.
 Post my disc back to me (enclose SAE) with the result sheet.
FINALLY
I WILL BE ATTENDING THE CHAMPIONSHIP:
Signed
 Friday
 Saturday
 Sunday
Date:
Method of Payment (£10.00 per sequence)
 Cheque — Please make cheque payable to ‘Royal Photographic Society NAVC’
 On line payment — Please log-onto your Bank Account and transfer the amount due
into; payee ‘Royal Photographic Society NAVC’ Reference ‘your name’
Sort Code 20-05-06 Account No. 10240583
Unless you have entered on line, please send the completed form together with your cheque (if applicable)
and disc to: Howard Bagshaw, 9 Haywood Heights, Little Haywood, Staffs ST18 0UR
to arrive no later than 28th July 2015
©April 2015