MIDSOUTH REGIONAL  FOR ACADEMY USE OFFICIAL ENTRY FORM ENTRY # __________________ THENATIONAL ACADEMY OF TELEVISION ARTS & SCIENCES NASHVILLE/MIDSOUTH CHAPTER EACH ENTRY MUST INCLUDE: 1. A VHS cassette with official labels (or photocopies) completed and affixed to both tape and tape box. 2. TWO completed copies, or computer-generated facsimiles, of the official entry form (or photocopies) of both sides for EACH entry. No attachments to entries, except Set Design. 3. Check, purchase order or credit card payable to NATAS NASHVILLE. 4. You must edit out commercial content leaving two to five seconds of black. 5. Send entries to: EMMY AWARDS, 161 Rains Avenue, Nashville, TN 37203 CATEGORY NUMBER ___24______ CATEGORY NAME _______Special Event Program/Live_________________ ENTRY TITLE ________Fourth of July Parade_____________________________ RUNNING TIME ____60:00_____ PRODUCING COMPANY _______Live Shots Are Us____________________________________________________ ORIGINAL AIRDATE __________7/4/02________________ STATION AIRED __________WXXX______________     PROGRAMS: CATEGORIES 1-41 CRAFTS:  CATEGORIES 42-60 MEMBERS $65 MEMBERS $45 NONMEMBERS $150 NONMEMBERS $130          PERSON(S) TO RECEIVE AWARD:   ENTRANT _ _ _ JOHN JONES_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ON SCREEN CREDIT  _ EXECUTIVE PRODUCER_ _ _ MEMBER __X__ NONMEMBER _____ ENTRY FEE $ _65.00_________   ENTRANT _ _ _ JANE JONES_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ON SCREEN CREDIT _ _ EXECUTIVE PRODUCER_ _ _ MEMBER __X__NONMEMBER _____ ENTRY FEE $ __65.00_________   ENTRANT _ _ _ BRIAN SMITH_ _ _ _ _ _ _ _ _ _ _ _ _ _ ON SCREEN CREDIT _ _ _HOST/PRODUCER_ _ _ _ _ _ MEMBER _____ NONMEMBER __X__ ENTRY FEE $ __150.00________   ENTRANT _ _ _ MARY SMITH _ _ _ _ _ _ _ _ _ _ _ _ _ _ON SCREEN CREDIT _ _ _ _PRODUCER _ _ _ _ _ _ _ _ _ MEMBER __X__ NONMEMBER _____ ENTRY FEE $ ___65.00________   ENTRANT _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ON SCREEN CREDIT _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ MEMBER _____ NONMEMBER _____ ENTRY FEE $ _______________   ENTRANT _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ON SCREEN CREDIT _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ MEMBER _____ NONMEMBER _____ ENTRY FEE $ _______________ When a SINGLE check covers MULTIPLE ENTRIES, a list of each category, name of entrant and individual entry fee MUST accompany the check. MEMBERSHIP FEES MUST be submitted on a SEPARATE CHECK, including a list of new members.   PERSON SUBMITTING ENTRY ______JOHN JONES___________________________________________________ ADDRESS ____123 MAIN STREET _____________________ _____________________________________________ CITY ________OUR TOWN__________________________________ STATE ____NC_______ ZIP __28200_______ TELEPHONE _____704-555-0000______________________________ FAX ___704-555-1111___________________ SIGNATURE ______John Jones________________________________E-MAIL______jj@internet.tv______________   Charge to American Express, VISA or MasterCard Credit Card      -     -     -      Card Holder Name:__________________________________________________ Expiration Date_______________   (Signature constitutes permission to screen and telecast all or portions of the entry as part of the Emmy Awards Program.) SYNOPSIS:  One hundred word limit of objectives, or any information you deem advantageous for the Judging Committee. Please use reverse side.