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'3*E'1) *3,JD Participation form 'D'3E : __________________________________ Name '3E 'D41J7 : _________________________________ Film title 'D(D/ : ____________________________________ Country 3F) 'D%F*', \ (D/ 'D%F*', : ___________________________ Production date 7HD 'DAJDE : __________________________________ Running time FH9 'DAJDE: B5J1 - *3,JDJ - *,1J(J - 'N.1 Animation experimental documentary short Fiction '3E 'DE.1, : _________________________________ Director name 'D,G) 'DEF*,) : _________________________________ Producer name F(0) EH,2) 9F 'DAJDE ('D91(J) H'D%FCDJ2J) (D' *2J/ 9F +E'F '371) Synopsis about the film In Arabic and English ( ( 8 lines only GD 'DAJDE EB/E DDE3'(B) 'D13EJ) - - F9E - - D' Is the film presented to Participate in the competition - -yes - -no F(0) 9F 'DE.1, Synopsis about the director filmograph #JF 916 'DAJDE B(D G0' 'DEG1,'F Where is your film screening Before the festival 9FH'F 'D4.5 'DE.HD 'DC'ED H1BE 'DG'*A H'D(1J/ 'D%DC*1HFJ Name, full address, Tel-number And Email of the participant F9E #H'AB 9DI %G/'! F3.) 'DAJDE %DI 'DEG1,'F Yes I agree to present thew film to The festival for their archive 'D'3E ______________ 'D*HBJ9 ________________ 'D*'1J. ________________ DD*H'5D HD%13'D #AD'ECE: EF 'D/HD 'D91(J) \ #H1H(' Salah SERMINI 36 Rue de Thionville 75019 Paris Tel : 0033/667948596 Fax : 0033/826698444  HYPERLINK "mailto:salah_sermini@hotmail.com" salah_sermini@hotmail.com ('BJ #F-'! 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