GOAFEST 2007 ENTRY FORM
Category Name: Category Number:
(P) Print (T) Television (O) Outdoor / Ambient (R ) Radio (DM) Direct Marketing (IM) Interactive Media
INFORMATION ABOUT THE ENTRANT:
Brand: Caption / Title:
URL (In case of Interactive Media):
Client (Person) Name: Designation:
Client Phone: Fax: Mobile: E-mail:
Client Company Name:
Client Company Address:
INFORMATION ABOUT THE RELEASE:
Date and Publication/Channel of First Release (only ads first released in 2006 are eligible):
Subsequent release on: in
INFORMATION ABOUT THE AGENCY/ENTRANT:
Names of contributors (Not more than 6 names.)
1. 2.
3. 4.
5. 6.
SELF CERTIFICATION: On behalf of the entrant, I declare that I am authorized to sign this certificate by my company and I have read and understood the rules, purpose and procedures of GOAFEST 2007 awards as given in this brochure. I am aware that in case of any of the above information as well as any part of this self certification being found untrue or unsatisfactory by the judges at the verification / final stage, this entry will automatically stand disqualified without assigning any reason / notice / consultation. In such a case, I affirm we shall abide by such a decision. I certify that the creative work being entered herewith was originally created by us and the client considers us, and no one else, as being creators of the work being entered. The work was released for the first time in the year 2006. It was produced based on a brief given by a client of ours whose details are as above. The release was a part of the advertising activity requisitioned by the client. The client has paid for its development as well as its release against the bills raised by us. Consolidated DD for entry fee @ Rs. 950/- per entry/per piece is enclosed.
Agency (Entrant):
Address:
Person's Name: