Channel SIGCSE 2009 Video Exhibition
(text) Submission Form

Instructions:
1.	Please complete this form by typing in the appropriate information. Fields are marked with *
2.	Then save this file with your information. 
3.	Email this document to dbouvie@siue.edu
4.	Attach a representative image (see below) to the email message when you submit this form.


The Submission:
	Title of the video *
	approx. Running time *
	YouTube URL *
A short description of the video (100 word limit, please).

 (include description here) *

Contact Person 
	name *
	institutional affiliation *
	address *
	city, (state) county, code *
	telephone *
	fax *
	e-mail *

Representative Image 
Create a single still image that we may use for promotional purposes. The image should be a 
single frame from your video. The image should be no less than 300 x 200 pixels.
Attach that image file to the email message when submitting this form.


Additional Contributors 
	name		
	institutional affiliation		
	e-mail		


Additional Contributors 
	name		
	institutional affiliation		
	e-mail		


Additional Contributors 
	name		
	institutional affiliation		
	e-mail