Peggy
Ezekiel Award/ Design Exhibit
Entry Form
PLEASE
PRINT OUT THIS FORM AND PRINT OR TYPE ALL INFORMATION
Name
______________________________________________
Address_____________________________________________
____________________________________________________
____________________________________________________
Email Address_________________________________________
Phone (work)__________________________________________
 (home)_____________________________________________
(cell -optional)________________________________________
Work
Entered_________________________________________
Producing
Organization___________________________________________
Address______________________________________________
_____________________________________________________
_____________________________________________________
Contact Person________________________________________________
Email Address_________________________________________
 Phone____________________________
Production
Dates______________________
Budget
__________________________
___Ezekiel
Award Entry
___Design
Exhibit Only (realized, unrealized and
project work)
Award
Class (Check One)
____
Academic (Non-student) ____ Community ____ Professional
____
Student: Undergraduate ____ Student: Graduate
(Academic
productions only) (Academic productions only)
Award
Categories (Check One)
____
Architecture ____ Costume Design ____ Costume
Technology
____
Lighting Design ____Makeup and Wig Design/ Technology
____
Scenic Craft ____ Scenic Design ____ Sound/System
Design
___
Technical Direction/ Engineering
____
USITT/ Ohio Valley Career Service Award
If
you do not wish for your work to travel with the
Design Exhibit,
please check here ___
GUIDELINES
USITT/
Ohio Valley Section members in good standing
may enter their own work for an Ezekiel Award
or the Design Exhibit
You
may Nominate for an Ezekiel Award: - Any work
by a member of USITT/ Ohio Valley Section
- Work by a non-member
produced within the USITT/ Ohio Valley Section
The
Nominator must be a member in good standing
of USITT/ Ohio Valley Section
Please
read the informational
page for more specifics, including submission
dates and directions for the physical presentation
and suggested content.
Mail entry form to:
Professor Matthew P. Benjamin
Department of Theatre Arts
Wright State University
3640 Colonel Glenn Highway
Dayton, OH 45435-0001
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