Entry Form |

Note: This form now can be used for both the Annual Film Contest and Hope and Justice contests.

2022 Entry Form

"*" indicates required fields

For the Annual Film Contest, this entry form is due March 1, 2022. The monthly contests are due by the end of each month. Every person that worked on the art project, film (crew) or acted in the film (cast) needs to provide contact information and accept the Directing Change Terms and Conditions (also referred to as the Release Form). If you are under the age of 18, the release form needs to be signed by a parent or legal guardian.

You can begin and then save this form uncompleted for up to 30 days at a time. At the bottom of the form you can click "Save and Continue Later". Once you click this you will be presented with a link that you need to bookmark and with an option to enter your email to receive the link via email. We strongly recommend doing both, as there is no way for the Directing Change Team to provide you with your link after the fact.

Release forms should be signed as soon as possible and will need to be sent to the Directing Change Team upon request. Release forms are required for projects to move onto judging and to receive awards. Once requested, we ask that all team members submit them within 5 days. To save yourself time and headache later, we recommend signing the release forms now by every person that worked on the submission. If you made a film this includes your cast. You can sign the release form online here.

If at any point you are experiencing an emotional crisis, are thinking about suicide or are concerned about a friend please call the National Suicide Prevention Lifeline immediately: 1-800-273-TALK (8255). This is a 24-hour hotline. Please share this information with anyone that is working with you on your film.*

I have read and acknowledge the above information

Information About Your Submission

Contest*

Let us know which contest you are entering.

Submission Group*

Mark Middle School Student if you are submitting your film/art piece as part of a class or club at your middle school.

Mark High School Student or Youth and Young Adult if you are affiliated with a high school.

Mark High School Student or Youth and Young Adult if you are submitting with an organization and are between the ages of 12-25. For example: you may be a community college or university student, part of a community-based organization or an after school youth program.

Visit the FAQ page for more information about this.

Middle School Students

High School Student or Youth and Young Adult (Grades 9-12 OR ages 12-25 not affiliated with a middle or high school)

Number of Participants in Creating Submission (Artist, Cast, and Crew)*

Please enter a number from 1 to 10.

Title of Submission*

Tell us about your submission*

Tell us a little about your entry and how your submission relates back to the required content submission criteria. Specifically, provide a description about your entry that we can share with the judges.

Please share why you chose this category*

Please share why you chose this category or any special effort that went into the entry, or something new that you learned or did as a result of working on this project.

Do you plan to submit an application to the Community Action Project as part of your submission?*

This category includes an additional incentive - a cash prize between $250 to $500 that can be used to support a community action project you create. Applications will be accepted on a rolling basis as funds are available and need to be started and completed between September 2021 and May 2022. Interested or have questions? Contact Us

Yes

Not Sure

Film Category*

Please select one of the following categories for your film to compete in.

Note that the Walk in Our Shoes category is only open to middle school students and you must choose one of these other categories in which to compete; if you are seeing this message and are a middle school student, please scroll back up to the Submission Group field and select "Middle School Student."

Suicide Prevention - 60 seconds

Mental Health Matters - 60 seconds

Through the Lens of Culture- Suicide Prevention- 60 seconds

Through the Lens of Culture - Mental Health Matters- 60 seconds

Animated Short - Suicide Prevention – 30 seconds

Walk in Our Shoes - 60 seconds (Middle School Only!)

Submission Format*

Film (30 Seconds)

Film (60 Seconds)

Film (TikToc)

Original music

Visual Art (painting, digital art, sketching, comic, or any other art form)

Written Works (blog, poem, spoken word or other narrative (500 words or less)

Other

Culture the Film Addresses*

Language of Film*

Upload your film (512mb max size)*

- Your film will be uploaded to the directing change vimeo.com account. Vimeo's terms and conditions can be found at https://vimeo.com/terms.
- Please upload your film as a mp4 or .mov file. Make sure the film size is less than 512mb or the form will not submit.
- Please also include a short summary/description of what happens in your film.

File*Title*Description

Upload your submission file here (Max 256mb)*

For more information on the types of files accepted, visit the Tips & Resources Page.

Please use jpg, gif or png format for art files.

Accepted file types: jpg, gif, png, pdf, mp3, Max. file size: 256 MB.

School/Organization Information

School/Organization Name*

School District Name (if applicable)

School/Organization Mailing Address*

Street Address Address Line 2 City ZIP Code

County Where School/Organization is Located*

Adult Advisor

This section to be filled out by the advisor

We are asking that all participants are associated with either a middle school, high school, college, university, community-based organization, program, club, or other entity and select an adult advisor for their team. The adult advisor is someone who is not on the film submission team. We are doing this so we can connect your school, club, or organization with free prevention resources. For questions or assistance with this please contact us.

Advisor's Name*

Cell Phone*

Email Where We Can Contact You*

Please provide an email that accepts mail from outside your organization (for example, a gmail.com address).

Work Agreement

As adult advisor I testify that this entry is a product of student/youth work. My role and that of other non-students in support of this entry were in advisement only.

Age Verification*

All students on the submission team are in grades 6, 7, 8, 9, 10, 11, or 12 or the lead youth on the film is between the ages of 12 and 25.

Participant 1

This is the lead artist or filmmaker who will receive award check and must meet age requirement

Name*

Email Where We Can Contact You*

Please provide an email that accepts mail from outside your organization or school (for example, a gmail.com account).

Phone*

Grade*

If you are finished with middle and high school, please select "Other"

Participant 1 - How would you describe yourself? (Mark all that apply)*

Hispanic

White

Black or African American

Asian

American Indian/Alaska Native

Native Hawaiian/Pacific Islander

Other

Participant 1 Gender Identity

Man

Woman

Gender Non-Conforming

Genderqueer/Non-Binary

Intersex

Transgender Man

Transgender Woman

Two Spirit

Other

Age Group*

Under 18

18-25

Parent Name*

Parent Email*

Emergency Contact - Name and Relationship*

Emergency Contact - Phone Number*

Terms and Conditions*

1. In consideration of my participation in the film that is being/has been uploaded (hereafter "Film") as part of the Directing Change Program and Film Contest, I hereby consent to the photographing, recording, or reproduction in any other manner of my likeness, voice and activities, in whole or in part, including the use of video and audio recordings and web use (hereafter “recordings”). I hereby waive any right that I may have to inspect or approve the finished audio and/or video recordings that may be used in connection herein. I understand that I will receive no monetary compensation for my participation in this production, nor may I make any monetary claim in the future for this participation.
2. Filmmaker(s) and the Directing Change Program and Film Contest shall be the exclusive owner(s) of “Film” and “Recordings” giving them the right to, without limitation, in perpetuity throughout the universe, in any and all languages, in any and all media know known or hereafter invented:(a) exhibit, broadcast, use, reproduce and license others to use as they see fit all or any part of the Film and the Recordings; (b) edit, dub, subtract from, add to or modify the Recording and the Film in any manner, combine it with any other material and/or incorporate it into other films, projects or programs; and (c) use and license others to use my name, voice, likeness, image, photograph, performance, participation, expressions, personal experiences and biographical material (collectively “Name and Likeness”), in and in connection with the production, distribution, advertising, publicity, promotion, exhibition and other exploitation of the Recordings, the Film, and in connection with The Directing Change Program’s products and services, an unlimited number of times, without any obligation of any kind to me whatsoever.
3. I represent that any music, images or other materials in the Recordings and the Film (and my furnishing of Pre-existing Materials, if any) are original or in the public domain and will not to the best of my knowledge (i.e., what I know or should know after the exercise of reasonable prudence) infringe upon the rights of any third party. I represent and warrant that I have all rights and authority to enter into this Waiver and Release (“Release”) and to grant the rights granted herein.
4. As used in this Release: (a) the term “Releasing Parties” means and refers to each of me, my heirs, next of kin, spouse, spousal equivalent, guardians, legal representatives, executors, administrators, successors and assigns; and (b) the term “Released Parties” means and refers to Filmmaker and the Directing Change Program and Film Contest and each and all of their respective parents, subsidiaries, related and affiliated companies, licensees, sponsors, successors and assigns, and the directors, officers, employees, agents, contractors, partners, shareholders, representatives and members of each of the foregoing entities.
5. I voluntarily assume any and all risks, known or unknown, associated with my participation in the Directing Change Program & Film Contest and actions and undertakings associated with my participation and the subsequent or simultaneous dissemination of the Recordings (collectively “my Participation”). I acknowledge that my Participation may present certain risks to me, and I hereby assume any and all risks associated therewith, including, without limitation, the risk of physical or mental or emotional injury, minor and/or severe bodily harm, and/or illness, which arise by any means.
6. I and the other Releasing Parties hereby voluntarily and knowingly, release, discharge and relinquish any and all claims, actions and lawsuits of any kind against the Released Parties related to or arising from my Participation, including, without limitation, travel to and from any location used in connection with the Film and Recordings, travel to and from the award ceremony, the making, taping, production, use, editing, distribution, licensing, and/or promoting of the Film and the Recordings and/or any portion thereof, including, without limitation, any claims, actions or lawsuits for wrongful death, negligence and/or other fault, either active or passive, personal injury, wrongful death, defamation, false light, violation of right of publicity, invasion of privacy, disclosure of embarrassing private facts, fraud, breach of contract, infringement of copyright, and negligent or intentional infliction of emotional distress.
7. I represent that I am at least 18 years of age, and that if I under 18 my parent or legal guardian has consented below.
8. I hereby agree not to assert any claim of any nature whatsoever against anyone relating to the exercise of the permissions granted hereunder.

I agree to these terms and conditions

Participant 2

Name*

Email Where We Can Contact You*

Please provide an email that accepts mail from outside your organization.

Phone*

Grade*

If you are finished with middle and high school, please select "Other"

Participant 2 - How would you describe yourself? (Mark all that apply)*

Hispanic

White

Black or African American

Asian

American Indian/Alaska Native

Native Hawaiian/Pacific Islander

More than one race

Other

Participant 2 Gender Identity

Man

Woman

Gender Non-Conforming

Genderqueer/Non-Binary

Intersex

Transgender Man

Transgender Woman

Two Spirit

Other

Age Group*

Under 18

18-25

Parent Name*

Parent Email*

Emergency Contact - Name and Relationship*

Emergency Contact - Phone Number*

Terms and Conditions*

I agree to these terms and conditions

Participant 3

Name*

Email Where We Can Contact You*

Please provide an email that accepts mail from outside your organization.

Phone*

Grade*

If you are finished with middle and high school, please select "Other"

Participant 3 - How would you describe yourself? (Mark all that apply)*

Hispanic

White

Black or African American

Asian

American Indian/Alaska Native

Native Hawaiian/Pacific Islander

More than one race

Other

Participant 3 Gender Identity*

Man

Woman

Gender Non-Conforming

Genderqueer/Non-Binary

Intersex

Transgender Man

Transgender Woman

Two Spirit

Age Group*

Under 18

18-25

Parent Name*

Parent Email*

Emergency Contact - Name and Relationship*

Emergency Contact - Phone Number*

Terms and Conditions*

I agree to these terms and conditions

Participant 4

Name*

Email Where We Can Contact You*

Please provide an email that accepts mail from outside your organization.

Phone*

Grade*

If you are finished with middle and high school, please select "Other"

Participant 4 - How would you describe yourself? (Mark all that apply)*

Hispanic

White

Black or African American

Asian

American Indian/Alaska Native

Native Hawaiian/Pacific Islander

More than one race

Other

Participant 4 Gender Identity

Man

Woman

Gender Non-Conforming

Genderqueer/Non-Binary

Intersex

Transgender Man

Transgender Woman

Two Spirit

Age Group*

Under 18

18-25

Parent Name*

Parent Email*

Emergency Contact - Name and Relationship*

Emergency Contact - Phone Number*

In the unlikely case we need to contact someone about this youth participant, please provide the phone number for an emergency contact here

Terms and Conditions*

I agree to these terms and conditions

Participant 5

Name*

Email Where We Can Contact You*

Please provide an email that accepts mail from outside your organization.

Phone*

Grade*

Participant 5 - How would you describe yourself? (Mark all that apply)*

Hispanic

White

Black or African American

Asian

American Indian/Alaska Native

Native Hawaiian/Pacific Islander

More than one race

Other

Participant 5 Gender Identity

Man

Woman

Gender Non-Conforming

Genderqueer/Non-Binary

Intersex

Transgender Man

Transgender Woman

Two Spirit

Age Group*

Under 18

18-25

Parent Name*

Parent Email*

Emergency Contact - Name and Relationship*

Emergency Contact - Phone Number*

In the unlikely case we need to contact someone about this youth participant, please provide the phone number for an emergency contact here

Terms and Conditions*

I agree to these terms and conditions

Participant 6

Name*

Email Where We Can Contact You*

Please provide an email that accepts mail from outside your organization.

Phone*

Grade*

Participant 6 - How would you describe yourself? (Mark all that apply)*

Hispanic

White

Black or African American

Asian

American Indian/Alaska Native

Native Hawaiian/Pacific Islander

More than one race

Other

Participant 6 Gender Identity

Man

Woman

Gender Non-Conforming

Genderqueer/Non-Binary

Intersex

Transgender Man

Transgender Woman

Two Spirit

Age Group*

Under 18

18-25

Parent Name*

Parent Email*

Emergency Contact - Name and Relationship*

Emergency Contact - Phone Number*

In the unlikely case we need to contact someone about this youth participant, please provide the phone number for an emergency contact here

Terms and Conditions*

I agree to these terms and conditions

Participant 7

Name*

Email Where We Can Contact You*

Please provide an email that accepts mail from outside your organization.

Phone*

Grade*

Participant 7 - How would you describe yourself? (Mark all that apply)*

Hispanic

White

Black or African American

Asian

American Indian/Alaska Native

Native Hawaiian/Pacific Islander

More than one race

Other

Participant 7 Gender Identity

Man

Woman

Gender Non-Conforming

Genderqueer/Non-Binary

Intersex

Transgender Man

Transgender Woman

Two Spirit

Age Group*

Under 18

18-25

Parent Name*

Parent Email*

Emergency Contact - Name and Relationship*

Emergency Contact - Phone Number*

In the unlikely case we need to contact someone about this youth participant, please provide the phone number for an emergency contact here

Terms and Conditions*

I agree to these terms and conditions

Participant 8

Name*

Email Where We Can Contact You*

Please provide an email that accepts mail from outside your organization.

Phone*

Grade

Participant 8 - How would you describe yourself? (Mark all that apply)*

Hispanic

White

Black or African American

Asian

American Indian/Alaska Native

Native Hawaiian/Pacific Islander

More than one race

Other

Participant 8 Gender Identity

Man

Woman

Gender Non-Conforming

Genderqueer/Non-Binary

Intersex

Transgender Man

Transgender Woman

Two Spirit

Age Group*

Under 18

18-25

Parent Name*

Parent Email*

Emergency Contact - Name and Relationship*

Emergency Contact - Phone Number*

In the unlikely case we need to contact someone about this youth participant, please provide the phone number for an emergency contact here

Terms and Conditions*

I agree to these terms and conditions

Participant 9

Name*

Email Where We Can Contact You*

Please provide an email that accepts mail from outside your organization.

Phone*

Grade*

Participant 9 - How would you describe yourself? (Mark all that apply)*

Hispanic

White

Black or African American

Asian

American Indian/Alaska Native

Native Hawaiian/Pacific Islander

More than one race

Other

Participant 9 Gender Identity

Man

Woman

Gender Non-Conforming

Genderqueer/Non-Binary

Intersex

Transgender Man

Transgender Woman

Two Spirit

Age Group*

Under 18

18-25

Parent Name*

Parent Email*

Emergency Contact - Name and Relationship*

Emergency Contact - Phone Number*

In the unlikely case we need to contact someone about this youth participant, please provide the phone number for an emergency contact here

Terms and Conditions*

I agree to these terms and conditions

Participant 10

Name*

Email Where We Can Contact You*

Please provide an email that accepts mail from outside your organization.

Phone*

Grade

Participant 10 - How would you describe yourself? (Mark all that apply)*

Hispanic

White

Black or African American

Asian

American Indian/Alaska Native

Native Hawaiian/Pacific Islander

More than one race

Other

Participant 10 Gender Identity

Man

Woman

Gender Non-Conforming

Genderqueer/Non-Binary

Intersex

Transgender Man

Transgender Woman

Two Spirit

Age Group*

Under 18

18-25

Parent Name*

Parent Email*

Emergency Contact - Name and Relationship*

Emergency Contact - Phone Number*

In the unlikely case we need to contact someone about this youth participant, please provide the phone number for an emergency contact here

Terms and Conditions*

I agree to these terms and conditions

If you have any technical issues or questions about entering, please call or email us:

Devin Saragosa-Harris: 858.324.4846 or devin@directingchange.org
Jana Sczersputowski: 858.740.4381 or jana@yoursocialmarketer.com
Stan Collins: 619.518.2412 or stan@suicideispreventable.org
For Hope and Justice entries – Shanti Bond-Martinez: shanti@directingchange.org