Jeevika 2012: Asia Livelihood Documentary Festival

Film Entry Form

Festival: 31 August - 2 September 2012, Delhi

Official Submission Deadline: 30 June 2012
Please go through the guidelines carefully before completing this form

Filmmaker Type:
Professional Filmmakers
(Submission Fee: INR 1000 / US$ 25)
Student Filmmakers
(Submission Fee: INR 500 / US$ 15)
Entry Type:
General Entry
(Screening Committee may select the film to be
screened under this non-competitive section)
Competition Entry
(Enables the jury to evaluate
and award the film)
Title of the Documentary in Original Language:
Title of the Documentary in English:
Original language of the Documentary:
Duration of film (HH/MM):   Date of Production:
Theme of the film:

Rural Livelihood Governance Human Rights Art and Culture Urban Livelihood

Globalisation Environment Gender Others (please specify):

Geographical area of the film (city, country):
Previous broadcasts or screenings (including other festivals and competitions):
In India:  
Other countries:  
Prizes won in film festivals/otherwise:  
Synopsis (up to 100 words in English)  
Please give some information on the background and context in which the documentary was made:  
Director of the Documentary: (In case of more than one director, please provide both names indicating the primary director, if applicable)
Name / Names:
Contact Address:
City / Town - State:   Postal Code:
Country:   Contact Number (Mobile preferably; Include country code):
Email:   Date of Birth:
Educational institution (if you are a student) or Organisation with which you are associated
Contact Address:
City / Town - State:   Postal Code:
Country:   Telephone (Include country code and area code):
Email:   Website  :
Course / degree currently being pursued (for students):
Main Crew Members with Designations:
PRODUCTION (Financial Support for the Documentary)
Source: Educational Institution Organisation Funding Agency Self
Concerned Person:
City / Town - State:   Postal Code:
Country:   Telephone (Include country code and area code):
Email:   Website:
Approximate production cost of the film:    
Nature of rights held:   Nature of rights given away:
How did you find out about Jeevika 2012:
Please attach your resume with filmography, if any. (only doc / docx / pdf file format accepted):  
Declaration for Participation:
I have read and understood the Jeevika 2012 guidelines and agree to abide by them. The copies of the documentaries (DVD only) will be kept in the CCS archives and they may be used for screenings at CCS and its partners programs.  A brief segment of the entry / promo may be used for promotional purposes. I hereby attest that all information provided is accurate and complete to the best of my knowledge.