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<div class="c-box wow fadeInRight mt-5"><form id="frm_node" class="contact-form" style="max-width: 850px; margin: auto;">
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<div class="col-12 col-md-12 mt-3"><span class="has-float-label"> <input id="fullname" name="fullname" type="text" class="form-control" required="required" placeholder="Nombre del representante &oacute; contacto"> <label for="fullname">Nombre del contacto</label> </span></div>
<div class="col-12 col-md-7 mt-3"><span class="has-float-label"> <input id="email" name="email" type="email" class="form-control" required="required" placeholder="Correo electr&oacute;nico"> <label for="email">Correo electr&oacute;nico de contacto</label> </span></div>
<div class="col-12 col-md-5 mt-3"><span class="has-float-label"> <input id="phone" name="phone" type="number" class="form-control" required="required" placeholder="Tel&eacute;fono"> <label for="phone">Tel&eacute;fono de contacto</label> </span></div>
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<div class="col-12 col-md-6 mt-3"><span class="has-float-label"> <input id="project_name" name="project_name" type="text" class="form-control" required="required" placeholder="Nombre del proyecto"> <label for="project_name">Nombre del proyecto</label> </span></div>
<div class="col-12 col-md-6 mt-3"><span class="has-float-label"> <input id="url_name" name="url_name" type="text" class="form-control" placeholder="URL del proyecto"> <label for="url_name">URL del proyecto</label> </span></div>
<div class="col-12 col-md-12 mt-3"><span class="has-float-label"> <textarea id="synopsis" class="form-control" name="synopsis" required="required" rows="7" placeholder="Ejemplo:

Rosa Amelia Hern&aacute;ndez es la protagonista que inspira este proyecto documental transmedia. Por medio del sitio web, su navegaci&oacute;n, contenidos period&iacute;sticos y diversos contenidos generados a partir de su lucha, se conocen otras historias que giran entorno a la aplicaci&oacute;n de ley de v&iacute;ctimas y restituci&oacute;n de tierras, de igual manera, a la violencia que est&aacute; directamente relacionada con los sucesos."></textarea> <label for="synopsis">Sinopsis</label> </span></div>
<div class="col-12 col-md-6 mt-3"><span class="has-float-label"><select id="topics" class="form-control" multiple="multiple" name="topics[]" required="required">
<option value="1" data-select2-id="40">Adolescencia</option>
<option value="2" data-select2-id="41">Arquitectura</option>
<option value="3" data-select2-id="42">Aventura</option>
<option value="4" data-select2-id="43">Ciencia</option>
<option value="6" data-select2-id="44">Ciudad</option>
<option value="7" data-select2-id="45">Cocina</option>
<option value="8" data-select2-id="46">Comedia</option>
<option value="9" data-select2-id="47">Conflicto Armado</option>
<option value="10" data-select2-id="48">Corrupci&oacute;n</option>
<option value="11" data-select2-id="49">Cotidianidad</option>
<option value="12" data-select2-id="50">Cuentos Rurales</option>
<option value="13" data-select2-id="51">Delincuencia</option>
<option value="14" data-select2-id="52">Deporte</option>
<option value="15" data-select2-id="53">Diario personal</option>
<option value="16" data-select2-id="54">Discapacidad</option>
<option value="17" data-select2-id="55">Diversidad</option>
<option value="18" data-select2-id="56">Educaci&oacute;n</option>
<option value="19" data-select2-id="57">Espacio P&uacute;blico</option>
<option value="20" data-select2-id="58">Expresiones art&iacute;sticas</option>
<option value="21" data-select2-id="59">Fantas&iacute;a</option>
<option value="22" data-select2-id="60">G&eacute;nero</option>
<option value="23" data-select2-id="61">Gentrificaci&oacute;n</option>
<option value="24" data-select2-id="62">Hist&oacute;rico</option>
<option value="25" data-select2-id="63">Identidad</option>
<option value="26" data-select2-id="64">Identidad de g&eacute;nero</option>
<option value="27" data-select2-id="65">Inclusi&oacute;n</option>
<option value="28" data-select2-id="66">Infantiles</option>
<option value="29" data-select2-id="67">Inteligencia Artificial</option>
<option value="30" data-select2-id="68">Maternidad</option>
<option value="31" data-select2-id="69">Medio Ambiente</option>
<option value="32" data-select2-id="70">Memoria</option>
<option value="33" data-select2-id="71">Migraci&oacute;n</option>
<option value="34" data-select2-id="72">Misterio</option>
<option value="35" data-select2-id="73">M&uacute;sica</option>
<option value="36" data-select2-id="74">Narraciones autobiogr&aacute;ficas</option>
<option value="37" data-select2-id="75">Pandemia</option>
<option value="38" data-select2-id="76">Patrimonio</option>
<option value="39" data-select2-id="77">Patrimonio Cultural</option>
<option value="40" data-select2-id="78">Pol&iacute;tica</option>
<option value="41" data-select2-id="79">Relatos Orales</option>
<option value="42" data-select2-id="80">Ruralidad</option>
<option value="43" data-select2-id="81">Salud mental</option>
<option value="44" data-select2-id="82">Sistema de Salud</option>
<option value="45" data-select2-id="83">Trabajo Informal</option>
<option value="46" data-select2-id="84">Tradici&oacute;n oral</option>
<option value="47" data-select2-id="85">Transformaci&oacute;n Social</option>
<option value="48" data-select2-id="86">Turismo</option>
<option value="50" data-select2-id="87">Violencia</option>
</select><label for="topics">Tem&aacute;ticas [Ctrl + Click seleccionar mas de uno]</label></span></div>
<div class="col-12 col-md-6 mt-3"><span class="has-float-label"><select id="media" class="form-control" multiple="multiple" name="media[]" required="required">
<option value="1" data-select2-id="12">Alb&uacute;m</option>
<option value="3" data-select2-id="13">App Dispositivos M&oacute;viles</option>
<option value="4" data-select2-id="14">Audio / Narraci&oacute;n Sonora</option>
<option value="5" data-select2-id="15">Blog</option>
<option value="6" data-select2-id="16">Comic</option>
<option value="7" data-select2-id="17">Conciertos</option>
<option value="8" data-select2-id="18">Cuento</option>
<option value="10" data-select2-id="19">Ebook</option>
<option value="13" data-select2-id="20">Fotogr&aacute;fia</option>
<option value="14" data-select2-id="21">Impresos</option>
<option value="15" data-select2-id="22">Instalaci&oacute;n</option>
<option value="16" data-select2-id="23">P&aacute;gina Web</option>
<option value="17" data-select2-id="24">Performance</option>
<option value="18" data-select2-id="25">Podcast</option>
<option value="19" data-select2-id="26">Productos Offline</option>
<option value="20" data-select2-id="27">Realidad Virtual O Aumentada</option>
<option value="21" data-select2-id="28">Seminarios Especializados</option>
<option value="22" data-select2-id="29">Serie Televisi&oacute;n</option>
<option value="23" data-select2-id="30">Serie Web</option>
<option value="24" data-select2-id="31">Televisi&oacute;n</option>
<option value="25" data-select2-id="32">Video Juegos</option>
<option value="26" data-select2-id="33">Videos Musicales</option>
<option value="27" data-select2-id="34">Visitas Tur&iacute;sticas</option>
</select><label for="media">Medios [Ctrl + Click seleccionar mas de uno]</label></span></div>
<div class="col-12 col-md-6 mt-3"><span class="has-float-label"><select id="gender" class="form-control" name="gender" required="required">
<option value="">G&eacute;nero</option>
<option value="1">Ficci&oacute;n</option>
<option value="2">No ficci&oacute;n</option>
</select><label for="gender">G&eacute;nero</label> </span><span class="form-error">Seleccione el g&eacute;nero del proyecto</span></div>
<div class="col-12 col-md-6 mt-3"><span class="has-float-label"><select id="year" class="form-control" name="year" required="required">
<option value="">A&ntilde;o</option>
<option value="1" data-select2-id="9">2009</option>
<option value="2" data-select2-id="10">2011</option>
<option value="3" data-select2-id="11">2012</option>
<option value="4" data-select2-id="12">2013</option>
<option value="5" data-select2-id="13">2014</option>
<option value="6" data-select2-id="14">2015</option>
<option value="7" data-select2-id="15">2016</option>
<option value="8" data-select2-id="16">2017</option>
<option value="9" data-select2-id="17">2018</option>
<option value="10" data-select2-id="18">2019</option>
<option value="11" data-select2-id="19">2020</option>
<option value="12" data-select2-id="20">2021</option>
<option value="13" data-select2-id="21">2022</option>
<option value="14" data-select2-id="22">2023</option>
<option value="0">En desarrollo</option>
</select><label for="year">A&ntilde;o</label> </span></div>
<div class="col-12 col-md-12 mt-3"><span class="has-float-label"> <textarea id="team" class="form-control" name="team" rows="7" placeholder="Ejemplo: 

Direcci&oacute;n: Juanita Le&oacute;n y Olga Luc&iacute;a Lozano 

Direcci&oacute;n creativa, coordinaci&oacute;n editorial y direcci&oacute;n y realizaci&oacute;n de la estrategia: Olga Luc&iacute;a Lozano y Marcela Pel&aacute;ez"></textarea> <label for="team">Equipo del proyecto</label> </span></div>
<div class="col-12 col-md-12 mt-3"><span class="has-float-label"> <textarea id="nominations" class="form-control" name="nominations" rows="7" placeholder="Ejemplo: 

*Festival Internacional de Documentales de Santiago

*Muestra Internacional Documental de Bogot&aacute;

*Festival de Cine del Caribe"></textarea> <label for="nominations">Nominaciones</label> </span></div>
<div class="col-12 col-md-12 mt-3"><span class="has-float-label"> <textarea id="awards" class="form-control" name="awards" rows="7" placeholder="Ejemplo: 

2013- *Premio Gabriel Garc&iacute;a M&aacute;rquez de periodismo, categor&iacute;a Innovaci&oacute;n. Colombia.

*Premio Alem&aacute;n de Period&iacute;smo y desarrollo. Alemania."></textarea> <label for="awards">Premios</label> </span></div>
<div class="col-12 col-md-12 mt-3"><span class="has-float-label"> <textarea id="funding" class="form-control" name="funding" rows="7" placeholder="Ejemplo: 

*La Silla Vac&iacute;a

*Fundaci&oacute;n Pr&iacute;ncipe Claus para la cultura y el desarrollo"></textarea> <label for="funding"> Financiaci&oacute;n </label> </span></div>
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