Endorsement Submission Form
Application for endorsement of films, DVDs, recordiings, apps, web series, web sites, screenplays, e-books and games. Also for recommendation of TV series. If you have any questions, please contact
or call 505-989.8076.
I am submitting for this category
Film or DVD
Audio recording, music or spoken word
TV Series (Recommendation)
TITLE OF PROGRAM
If part of a series, name of the series
JUDGING COPIES FORMATS
Audio CD (3)
Online Screener (provide password below in "other")
Product Sample, Games (3)
Link to web site. If password required, include in notes below
Interactive Media Format
If a game or app, what platform can it be played on (iPhone, iPad, X-box, Playstation, etc.)
Please answer each question below. Type N/A if the question does not apply to your entry.
RUNNING TIME (in whole minutes)
Round off to whole number. Do not put fractions of a minute. For linear media only.
RELEASE DATE. Format (mm/dd/yy)
Only for media that has been or will be released to public
SUGGESTED RETAIL PRICE OR MSRP
Only for media that has been or will be released to public. If a screenplay or hasn't been released, please enter n/a
250 character (not word) max. Describe the program and what happens in it. Avoid exclamatory words. Stick to the facts. Be specific. Do not repeat the title. Do include celebrity talents. Do make it engaging. Provide password if submitting online screener.
List 7 keywords. Use words that would be used in a search to find your program.
Select the category that best fits your product.
Nature / Environmental
Student Filmmaker? Only answer if you are a student)
If this is a student production, select student category and include your student ID with your submission.
Middle School Student
High School Student
Indicate the best singe age group. If our Jurors feel your product is suitable for a different age group, we will adjust it accordingly.
Indicate the genre of your program
LANGUAGE AND SUB-TITLES
Indicate the primary language of your entry. If film/DVD entry is in a foreign language it must be subtitled in English.
Person who is the primary contact for this entry.
Contact Person's Title
If contact person has a title, include it here.
Contact Person's Email Address
Name of producer or distributor that is submitting this entry. This name will be on your endorsement certificate.
If awarded, name and postion of person on award.
Award will default to the name of the Entering Organization unless you supply a different name here.
Mailing Address (street, city, state, zip)
Include street name and number, apt #, city, state and zip.
Phone Number, daytime
Phone Number, cell
Is there anything else you need to tell us about your entry?
Select from below, your fee category.
Your membership must be current to take advantage of member's fee. Go to
for new membership info or contact us to check on your membership status.
Member fee. Film, DVD, Music, Games, Web Series, Website, - $100
Member fee. TV Series - $200
Member fee: App, E-book, Screenplay - $55
Member fee: Music Video 10 min max - $35
Non Member fee. Film, DVD, Music, Games, Web Series, Website - $150
Non Member fee. TV Series - $300
Non Member fee. App, E-Book, Screenplay - $75
Non-Member fee: Music Video 10 min max - $50
Rush or late fee
If you need an endorsement outside our normal deadlines, we can do it for you within 2 weeks for an additional fee (except during the holidays)
Rush or late fee - $50
Your application is not complete until payment is made, and cannot be processed without payment and judging copies.
I will pay online through PayPay right after submitting this.
I will mail a check or money order (US Bank only)
SCROLL ALL THE WAY DOWN ON THIS FORM AND HIT SUBMIT.
Never submit passwords through Google Forms.
This form was created inside of Coalition for Quality Children's Media.
Terms of Service