Personal Informations First name : Last name : Nickname : Adress : Postal Code : City : State : Country : Phone : Mobile : email : Informations relatives au Clip Title : Track(s) used : Artist(s) : Anime(s) : Sending Method : [ ] email -> [ ] Direct link : http:// -> [ ] FTP Acces request [ ] standard mail -> [ ] CD -> [ ] DVD By registering me in this contest, I certify to have read and approuved the reglementation : http://www.fantasy-movies.net/concours/reglement_int_2005.pdf Signature: Association Fantasy movie wont to reveal your telephone numbers and addresses. Send this form by email to : amvcontest@fantasy-movies.net or by mail to : Association Fantasy Movies Sébastien Moricard 10, rue du Colonel Delorme 93100 Montreuil FRANCE