ENTRY FORM

Music (If any used):

Courageous Persuaders Royalty Free Track Number:

Other Music Title and Source (Attach permission for use):

TITLE OF COMMERCIAL:
Date Submitted:

Team Member Name:

Phone Number:

e-mail:

School Name:
City & State:

Team Captain Name:

Phone Number:

e-mail:

Team Member Name:

Phone Number:

e-mail:

Team Member Name:

Phone Number:

e-mail:

Team Member Name:

Phone Number:

e-mail:

Tracking Number:
(To be completed by Courageous Persuaders Office)

 

Video Cassette Label

COURAGEOUS PERSUADERS
TITLE OF COMMERCIAL:
Date Submitted:
School Name:
City & State:
Team Captain Name:
Phone Number: