ITVS: International Call Application Form

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Online Application

You may submit Part I of your application online. You will be given an opportunity to view and make changes to your application information after filling out this page. Upon submitting Part I electronically, you will be prompted to print and sign the application form and use it as the cover sheet when submitting the remainder of your materials.

Before completing this form make sure you have read the International Call 2009 Guidelines and How to Apply.

Enter all applicable information below and select Proceed to Confirmation when finished. Asterisks (*) indicate required fields.

PROGRAM INFORMATION

Program Title - English

Program Title - In Native Language

Brief Summary of Proposed Program (25 words or less)

Length:

Genre:

Documentary

If Other, please specify:

Shooting Format:

BETA
DV
HD

16 mm
35 mm
Other

Select the primary country where this program occurs:

Please enter any other countries where this program occurs:

Select the primary language spoken in this program:

APPLICANT INFORMATION

Name of Applicant* First: Last:
Role in production: Name of Production Entity (if applicable)
Address*
City*	State/Province	Zip/Postal Code
Country*
Phone 1*		Type*
Phone 2		Type
Email Address*		Fax

BACKGROUND INFORMATION FOR REPORTING PURPOSES ONLY
ITVS is dedicated to presenting diverse voices on television. We continually strive to assure that the pool of applicants reflects a wide spectrum of communities. To this end, we respectfully request the demographic information below. This section is optional. Your participation helps us measure the effectiveness of our efforts.

Country of Citizenship*

Gender:

Age:

Other community:

LGBT
Disability
Other

If Other, please specify:

How did you hear about INTERNATIONAL CALL?

If Other, please specify:

CO-APPLICANT INFORMATION

Name of Co-Applicant First: Last:
Role in production: Name of Production Entity (if applicable)
Address
City	State/Province	Zip/Postal Code
Country
Phone 1		Type
Phone 2		Type
Email Address		Fax

LGBT
Disability
Other

If Other, please specify:

INFORMATION ON SUPPORTING VIDEO MATERIALS

Work-in-Progress 3 copies (required)

Type:

Length

Work-in-Progress Format:

Previously Completed Work Sample 1 copy (required)

Title:

Length

Format:

Role:

BUDGET SUMMARY

Cash Spent to Date

Cash Secured Not Yet Spent

Description

Pending Funds

Description

Total Request to ITVS

Total Budget of Program

Once all of the information above is complete and correct, you must:

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