1. Have you registered for this contest?

   Yes, I have registered.
   No. (If your answer is no, go register before proceeding)
   
   

2. Please provide the following contact information. This information should be the same as on your registration form. 

   First Name
   Last Name
   Middle Initial (optional)
   Home Phone (at least one phone # required)
   Cell Phone (optional)
   E-mail

3. Enter your video topic (a short 1 to 5 word title or description):

   
   

4. Indicate the length of your video.  Maximum allowed length is 3 minutes!

   Short -- 30 Seconds or 60 Seconds
   Long -- up to 3 Minutes Maximum.
   
   

5. Enter the URL to your YouTube video (this MUST be accurate or we will not be able to find your video):

   
   

   RELEASE STATEMENT:

   I (we) grant the Alliance a royalty-free license to copy, distribute, modify, display and perform publicly and otherwise use, and authorize others to use, the submitted video for any educational purpose throughout the world and in any media. I grant the Alliance the right to make the video available to the general public from its website and to distribute it to environmental groups and any other organizations interested in showing it for educational purposes, including, but not limited to, on internet sites, at conferences and events, on television, and other media outlets. 

   By submitting your video URL to the Alliance, you agree to the above release statement. 

6. ADDITIONAL ACTORS/PARTICIPANTS.  If you work in groups, list below the name and contact information of each person who participated. Also, list the name and contact information, including phone and email, for EACH person appearing in the video, even if they are not part of the your group. Each person must agree to the release statement (above). If your video is selected as a finalist, each actor will be required to sign a release form to allow the Alliance to use your video. If the actors are minors, a parent or guardian must also sign their release forms. 

   
   

After you hit the Submit Form, you will receive a Confirmation Page. Check it to be sure you have entered the information correctly, especially the URL. 

If you have any problems or questions, contact the Alliance at 480-422-7392 or email GreenArizona@azalliance.org. 

Thank you for participating!