三影堂摄影艺术中心 Three Shadows Photography Art Centre 北京朝阳区草场地 155 号 A（100015） 155A Caochangdi Chaoyang District, Beijing, 100015 Tel/Fax: 86-10-64322663 - 8004 E-mail: infothreeshadows.cn Website: www.threeshadows.cn2015 年度第七届三影堂摄影奖参选报名表年度第七届三影堂摄影奖参选报名表 Seventh Annual Three Shadows Photography Award Registration Form参选方式：请参选者于 2014 年 12 月 31 日前提供以下参选资料： 详细填写的参选报名表（包括所附简历/个人介绍、每幅作品详细情况等） 5-20 幅本人作品样片（不超过 A4 幅面的照片或打印样片） 包含作品电子图（jpg、tiff 格式） 、填写完整的参选表格在内的光盘一张 Please submit the following application materials before December 31, 2014: Fill out all portions of the registration form, including the CV or personal statement page and a detailed description of each work. Provide 5-20 of your works. Works are not to exceed the size of a sheet of A4 paper. Digital applications, including works in either .jpg or .tif format and a completed registration form, must be submitted on a single CD. 以上资料投递至： 北京市朝阳区草场地 155 号 A 三影堂摄影艺术中心 三影堂摄影奖评委会收 邮政编码：100015 The above materials can be mailed to: Three Shadows Photography Award Three Shadows Photography Art Centre 155A Caochangdi Chaoyang District, Beijing, China 100015可使用挂号邮递以防遗失。参选资料仅用于评委对参赛者进行了解和甄选，恕不退还。 暂不接受电话、电邮报名或投递资料。 You can use registered mail to prevent the loss of your application. Applicants materials will only be used to evaluate applicants. Unfortunately, applications will not be returned. We cannot accept telephone or email registrations or delivered applications.本人已了解并接受三影堂摄影奖的参选规则。 I understand and accept the Three Shadows Photography Award selection criteria. 本人谨此声明此份报名表里所提供的信息是全面且正确无误的。 I declare that the information I have provided in this registration form is correct and complete.姓 Family Name名 Given Name性别 Gender 身份证/护照号码 ID Card / Passport Number出生日期 Date of Birth 固定电话 Phone移动电话 Mobile Number电邮 E-mail网站 Website联系地址 Address 三影堂摄影艺术中心 Three Shadows Photography Art Centre 北京朝阳区草场地 155 号 A（100015） 155A Caochangdi Chaoyang District, Beijing, 100015 Tel/Fax: 86-10-64322663 - 8004 E-mail: infothreeshadows.cn Website: www.threeshadows.cn签名 Signature：_日期 Date：_提醒：请使用中英文填写与提交相关资料。如果您提供了虚假的信息或提交不符合要求的参选资料，您将无权参与此次评 选。 参选者必须在打印版的参赛表格上亲笔签名。 三影堂摄影奖评选委员会对此次评选拥有最终解释权。 Note: Please use Chinese or English to fill in the form. If you provide false information or your submissions dont adhere to the above requirements, you will be ineligible for this competition. The printed copy of your registration form must have an original signature. The Three Shadows Photography Award judges have the ultimate power to interpret the above requirements.三影堂摄影艺术中心 Three Shadows Photography Art Centre 北京朝阳区草场地 155 号 A（100015） 155A Caochangdi Chaoyang District, Beijing, 100015 Tel/Fax: 86-10-64322663 - 8004 E-mail: infothreeshadows.cn Website: www.threeshadows.cn个人简历/自我介绍 CV or Personal Statement (200 words or less)三影堂摄影艺术中心 Three Shadows Photography Art Centre 北京朝阳区草场地 155 号 A（100015） 155A Caochangdi Chaoyang District, Beijing, 100015 Tel/Fax: 86-10-64322663 - 8004 E-mail: infothreeshadows.cn Website: www.threeshadows.cn作品阐述（300 字以内） Description of Artwork (300 Words or Less)作品清单作品清单 Works List三影堂摄影艺术中心 Three Shadows Photography Art Centre 北京朝阳区草场地 155 号 A（100015） 155A Caochangdi Chaoyang District, Beijing, 100015 Tel/Fax: 86-10-64322663 - 8004 E-mail: infothreeshadows.cn Website: www.threeshadows.cn编号 Number作品名称 Artwork Name材料/制作工艺 Material/ Process尺寸 Size创作时间 Year