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Fundamental Rights Agency
> EU-Fundamental Rights Video Competition 2010 - Submission Form
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E-mail address:
First Name
:
Last Name:
Street Address:
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Zip/Postal Code:
Country of Residence:
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Gender:
Male
Female
Phone (including country code)
Academic backg
round
Are you currently a student?
Yes full-time
Yes part-time
No
If yes, please indicate your school or university
Are you currently employed?
Yes full-time
Yes part-time
No
If yes, please indicate the name of your employer
Additional Information
How did you find information about the Video Competition?
Internet
Poster at my university
On the Fundamental Rights Agency website
Email from the Fundamental Rights Agency
Other
Would you like to receive information about other Fundamental Rights Agency initiatives for youth?
No
Yes
Only about the Video Competiton
Would you like your video to be posted on the Video Competition website
?
No
Yes
Only if I'm a finalist
Submission
Language (of the video or of its subtitles):
English
German
French
Spanish
Italian
Title of your video:
Link to your video:
Description of your video (max 150 words):
Please read the following statements and indicate your agreement:
I have read and I accept the
rules of the competition
. I certify that this video is my own production and has not been entered for competitions before. I certify that I have submitted only one video. I agree that my work is published and disseminated by the Fundamental Rights Agency, in the original or modified format. I understand that I will not be remunerated for the publication of my work and that the publication does not entail any further commitment from the Fundamental Rights Agency.
I agree to the
rules for participation
in the 2010 Video Competition, I live in the EU and I am at least 18 and not older than 30 years of age as of May 9, 2010.
I agree
Last update 17/02/2010