Date 2015. Application No. . . - ※Operation office authorised will fill in. 2015 Gwangmyeong International Fantasy Conceptual Design Contest Application Form • Professionals ⃞ Application Section • Non-Professionals (Students from primary school, middle school, high school, (⍌ tick the box) University and amateurs Contest Theme (⍌ tick the box) ⃞ 1. Concept Design / Professionals / Mirror Earth ⃞ 2. Concept Design / Non-Professionals / A monster in my closet 3. Illustration / Any Fantasy theme as you wish ⃞ (Korean) Name • Concept Design ⃞ • Illustration ⃞ (English) ⃞ The year and date of birth & Country Address (Tel) Contact number (Mobile) Email The title Of your work Explanation of your work Weta Workshop Fantasy Academy • If and when my work is successfully chosen, I’d like to attend Weta Workshop Fantasy Academy. ⃞ • Despite my work is successfully chosen, I am afraid that I’d rather not to attend Weta Workshop Fantasy Academy. ⃞ I would like to submit my work to the <2015 Gwangmyeong International Fantasy Conceptual Design Contest> co-hosted by Gwangmyeong city & Film Alchemy and supported by Weta Workshop. If and when my work is selected, I clearly understand that I will hand over two copies of my work and am please to exhibit them overseas for two months. I duly confirm that I apply for this contest. 2015. . . Applicant (signature) Operation Committee of 2015 Gwangmyeong International Fantasy Conceptual Design Contest * We will contact you as above information, please make sure the personal information you write on is correct.