Motion Picture Details
Title of Motion Picture: *
Studio or Production Company:*
Name of stunt person(s) as listed in the credits:*
Category for which performance is being submitted (please choose one)
Stunt Details
Brief Description of Stunt:*
Position of stunt in film (time in/out minutes): *
Stunt Coordinator and/or 2nd Unit Director:*
Identification of Person making Submission
Please fill out the following information about yourself:
First Name: * Zip Code: *
Middle Name: Country: *
Last Name: * Phone: *
Company: Fax: *
Street Address: * Email: *
City / State: *  
Relation to Stunt performer: *