Dr. E. Sathya Prakash,
Assistant Professor of Communication,
Sarojini Naidu School of Arts & Communication,
University of Hyderabad,
Gachibowli, Hyderabad 500046, India.
My name is ______________________________________. I am (pursuing/working as) ______________________________________ (name of the course/profession) at ______________________________________ (name of the Institution/Organization).
I/We have produced the short film titled ______________________________________ for Indialogue Short Film Contest 2013 – ‘Peaceful Coexistence’. I/We herewith submit the above mentioned work for this contest. And I/We authorize Indialogue Short Film Contest organizers to promote and publicize the same.
I/We declare that:
The film is original work of mine (or group) and I/We have not infringed the copyrights, trademarks, rights of privacy, publicity or any other intellectual property or rights of any person or entity. And I/We also state that the film doesn’t have any unlawful content.
Name of Participant (representative of the group)
Stamp and Signature
Head of Institution
Note: Professionals and Freelancers do not need to get endorsed from their affiliated organization.