CCA Entry Form
 
The creative work is
Published
Unpublished
If published, in which media
Date of release
Creative Director:
A brief description of achievements:
Visualiser / Art Director:
A brief description of achievements:
Copywriter:
A brief description of achievements:
Photographer / Illustrator:
A brief description of achievements:
Title of Advertisement:
Thought behind the advt.:
Agency:
In case of freelancers please mention some of your clients:
We assure the judges that this work is orginal in content and has been conceived by us.
Name
Designation
Company Name & Address
City
State
Phone
Mobile
Email
If my entry wins, the cheque for the prize amount should be made in the name of (single) person or organization, mention below. I am writing this after receiving due consent & authorization of all involved in the creation of this advt.
Name
Address
PAN No. (or Identity card no.)
If I win I may be intimated on.
Email
Mobile
I accept all the rules and regulation for participation.
Attach your file :

Accept JPEG file only (size not more then 2mb)

(Optional) I would like to authorize Rajasthan Patrika to allow any NGO/ organization working for social work to use my ad for 1 year to promote this social cause, free of cost.
Yes
No
Please read all the rules and regulations before submitting the form by clicking the "Contest Rules" button at the top of the form.