Around The Block / Al Doblar La Esquina Theatrical arts and sciences in NYC communities 5 East 22nd Street, Suite 9k New York, NY 10010 http://www.aroundtheblock.org info@aroundtheblock.org 212-673-9187 As part of our annual Urban Arts Festival Spring 2006 Application for the Raymond J. Flores Short Play Series Please Fill In All Information 1. Name: 2. Address: 3. Telephone(s): 4. email: 5. Around The Block member (y or n)? 6. Play(s): (maximum of 12 minutes each; plays must not have been produced, published or optioned) ________________________________________________________________ | Title of Work |Estim. length (minutes)| |______________________________________|_______________________| | | | |______________________________________|_______________________| | | | |______________________________________|_______________________| | | | |______________________________________|_______________________| Submitted scripts will not be returned. May we keep them for our archives? Yes No (destroy) Your signature below constitute acceptance of these terms. Submitted by: ____________________________________ Date: ____________________________________ Mail completed form, script, application check, and a one paragraph bio to: Around The Block 5 East 22nd Street, #9k New York, NY 10010 Or email script and a bio to info@Aroundtheblock.org, and send by U.S. Mail a completed form together with a check for the application fee (or Around The Block membership dues, if you are not already a member) to the above address. Submission Deadline: Submission must be received by November 30, 2005.