Video Contest: Entry Form | Doctors for Global Health

Full Name: *

Email Address: *

Phone Number (Include Area Code): *

Zip Code: *

Country: *

Submission Title: *

(Use of 'Untitled' permitted)

Duration: *

Submission URL: *

(Enter a direct link to your video hosted on a personal or video-sharing website)

Description of the video: *

(Tell us about your movie in 100 words or less)

All content of video work is original and includes only music, footage, artwork, text, etc., for which rights have been obtained.

By submitting, you grant Doctors for Global Health permission to use your video for outreach purposes.