APPLICATION FORM SMPIA Cross Media Delegation to Banff

							         CROSS-MEDIA DELEGATION TO BANFF
                APPLICATION FORM
Film/Television Company Applicant:
(For the purposes of this project, a Film/TV company is defined as a company that derives its primary
source of revenues from the creation of Film/TV media products)

Name: _____________________________________ Title: ____________________________________

Company name: ______________________________________________________________________

Address:_____________________________________________________________________________

City: _______________________________________, Saskatchewan P.C. ______________________

Main #: ___________________ Cell: ________________ Email: _______________________________

□ I hold a valid membership with SMPIA □ I have attached my company profile/bio
Interactive Company Applicant:
(For the purposes of this project, an interactive company is defined as a company that derives its primary
source of revenues from interactive media products)

Name: _____________________________________ Title: ____________________________________

Company name: ______________________________________________________________________

Address:_____________________________________________________________________________

City: _______________________________________, Saskatchewan P.C. ______________________

Main #: ___________________ Cell: ________________ Email: _______________________________

□ I hold a valid membership with SMPIA □ I have attached my company profile/bio
Project Description:
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Please describe what project visuals will be available to display during the pitch competition in Regina on
        th
March 27 ?
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Please explain why your team would like to participate in the delegation and what you hope to gain from
the experience.

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You may include the above information in attached documents if you prefer.

Please note: Participation in this delegation is valued at $5000/team but will be offered free of cost
thanks to the support of our sponsor.

By signing below, I acknowledge that I have read, understand and agree to the regulations of the Cross-
Media Delegation to Banff and commit to fulfill all the requirements of the initiative if selected as a
delegate.

Film/TV Company representative signature: _________________________________

Interactive Company representative signature:_________________________________



                             Questions and applications can be directed to:
                             Nova Alberts – Digital Media Initiative Manager
                            Saskatchewan Motion Picture Industry Association
                             Phone: 306-565-2002 Email: nova@smpia.sk.ca


                            The Cross-Media Delegation to Banff is being delivered by
                        SMPIA (Saskatchewan Motion Picture Industry Association) thanks to
                             the receipt of a Culture on the Go: Market Access Grant.

                         Culture on the Go is made possible through funding provided to the
                                              Saskatchewan Arts Board
                                        by the Government of Saskatchewan
                              through the Ministry of Tourism, Parks, Culture and Sport