Instructional Video Listings

Submission Form

This form is divided into two parts:

Information on how to contact you, the producer
Listings for up to 10 individual videos (if you have more than 10, please complete an additional form for the extras)

How to Contact You for Information on Ordering, Pricing

Postal Address:
Company Name
Street Address Line 1
Street Address Line 2
City
State/Province
Zip/Postal Code
Country

Telephone & Internet:
Telephone (Put Country Code in the first box, for example, "1" for U.S. or "49" for Germany)	(+)
Fax	(+)
E-Mail Address
Web Site Address (don't type the http:// part)	http://

Do you have agents acting as your wholesaler in other countries? If so, please provide the same contact information as requested above for each representative.

Video List

Please complete an individual form for each video. If you have volumes 1 through 10, please fill out each of 10 forms, one for each volume.

Video #1

Short Title (50 Characters or Less)

Full Title

Language Used for Teaching

Featured Instructor

Number of Minutes in Length

Formats Available (Check all that apply) NTSC (the format used in U.S. & Canada)
PAL
SECAM

Media Available (Check all that apply) VHS Tape
DVD (specify Regions available: )
VCD

What is the video about? (50 Characters or Less)

Category (Check only one) Basic Moves (Brand-New Beginners)
Continuing Education (Experienced Beginner, Intermediate)
One of these Specialties:
     Choreography Instruction
     Single Veil, Double Veil, Cape
     Finger Cymbals
     Arms
     Floor Work
     Balancing (Sword, Candle, Shamadan, etc.)
     Cane
     Fan
     Costuming or Make-Up
     Other (describe: )

Internal Comments to Shira (will NOT be published)

If you don't have any more videos to describe, click here to jump to the bottom of the form where the "Send" button is.

Video #2

Short Title (50 Characters or Less)
Full Title
Language Used for Teaching
Featured Teacher or Performer
Number of Minutes in Length
Formats Available (Check all that apply)	NTSC (the format used in U.S. & Canada) PAL SECAM
Media Available (Check all that apply)	VHS Tape DVD (specify Regions available: ) VCD
What is the video about? (50 Characters or Less)
Category (Check only one)	Basic Moves (Brand-New Beginners) Continuing Education (Experienced Beginner, Intermediate) One of these Specialties: Choreography Instruction Single Veil, Double Veil, Cape Finger Cymbals Arms Floor Work Balancing (Sword, Candle, Shamadan, etc.) Cane Fan Costuming Or Make-Up Other (describe: )
Internal Comments to Shira (will NOT be published)

If you don't have any more videos to submit, click here to jump to the bottom of the form where the "Send" button is.

Send Your Information

Please carefully review the above information. When you're certain everything is correct, click "Send Now":