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									                                                                                                  For Telefilm Canada use
                        Telefilm Canada
                                                                                                  Application #
                        Festivals Performance Program                                             Date Received
                        Application Form                                                                              Y          M         D
                                                                                                                                     Page 1 of 5


Applicants should be familiar with the Festivals Performance Program Guidelines and the applicable Telefilm Canada
business policies prior to completing this application form. Please complete all information requested and include all
relevant documentation with your application. Please note that this application form must be signed by all approved
applicants prior to submission to Telefilm Canada.

TITLE OF FESTIVAL                                                            DATE(S) OF THE FESTIVAL*

*Note: Applications received less than 10 weeks prior to the Festival may be deemed ineligible.



LEGAL NAME OF APPLICANT COMPANY                                              LEGAL NAME OF CO-APPLICANT COMPANY(IES) (AS APPLICABLE)


ADDRESS                                                                      ADDRESS


CITY                    PROVINCE                    POSTAL CODE              CITY                    PROVINCE               POSTAL CODE


TELEPHONE                            FAX                                     TELEPHONE                        FAX
(     )          -                   (      )           -                    (     )         -                (     )       -
E-MAIL FOR OFFICIAL                                                          EMAIL FOR OFFICIAL
NOTIFICATIONS                                                                NOTIFICATIONS
WEB ADDRESS                                                                  WEB ADDRESS
CONTACT FOR THIS FILE (NAME & TITLE)         DIRECT LINE
                                             ext.
PRINCIPAL EXECUTIVE (S) / SIGNATORY




HAS THIS APPLICANT EVER APPLIED TO TELEFILM CANADA FOR SUPPORT?          Yes                             No
If it has received funding, please provide the following information:
AMOUNT                   DATE OF CONTRACT                             PROGRAM                                       APPLICATION NUMBER
$
$
$
                                 Y                  M              D


BRIEF DESCRIPTION OF THE FESTIVAL (100 WORDS OR LESS)




CULTURAL CONTENT         Cultural content refers to festival only – NOT festival personnel
(CHECK ONLY ONE):        (Note: this information is gathered for statistical purposes only)
    Aboriginal           Festival must focus PRIMARILY on aboriginal activities or issues
                         Festival must focus PRIMARILY on visible minority activities or issues OR activities or issues based on first
       Multicultural
                         generation immigrants to Canada from Eastern Europe or Latin America
       General           All other Festivals




                                                                                                                                          TFC0810
Telefilm Canada Festivals Performance Program
Application Form
                                                                                                                                         Page 2 of 5

KEY FESTIVAL PERSONNEL          NAME                                                                                                  CITIZENSHIP*
Chair
Executive Director
Director of Programming
Project Manager
OTHER KEY PERSONNEL (AS APPLICABLE)
Head of Admin. & Finances
Head of Communications
Head of Development
Head of Sponsorships
Head of Marketing
Head of Production
Other:
*If “Canadian”, in accordance with the Investment Canada Act, the Immigration and Refugee Protection Act or the Citizenship Act



                                                                                            PENDING/         TYPE OF                        % OF
PROPOSED TOTAL FINANCING         SPECIFY LEGAL NAME OF COMPANY OR ORGANIZATION                                               AMOUNT
                                                                                           CONFIRMED        FINANCING                       TOTAL
Telefilm Canada – Festivals Performance Program                                              Pending       Contribution           $                  %
Other Federal Government                                                                                                          $                  %
Provincial Government                                                                                                             $                  %
Municipal Government                                                                                                              $                  %
Other                                                                                                                             $                  %
subsidies/contributions
Cash Sponsors                                                                                                                     $                  %
Sponsors in Kind                                                                                                                  $                  %
Independent Income                                                                                                                $                  %
Donations                                                                                                                         $                  %
Other Income                                                                                                                      $                  %
Total Canadian Financing                                                                                                          $                  %
Other                                                                                                                             $                  %
Other                                                                                                                             $                  %
Total Foreign Financing                                                                                                           $                  %
Total Financing                                                                                                                   $                  %


BUDGET
DATE OF SUBMITTED BUDGET:                                                                                      TOTAL BUDGET:                 $
                                      Y             M             D




                                                                                                                                           TFC0810
Telefilm Canada Festivals Performance Program
Application Form
                                                                                              Page 3 of 5

                                                    FESTIVAL DETAILS


LOCATION(S) OF FESTIVAL
PROJECTED AUDIENCE FOR FESTIVAL
PROJECTED NUMBER OF FEATURE LENGTH FILMS (75 MIN AND MORE)
PROJECTED NUMBER OF CANADIAN FEATURE LENGTH FILMS (75 MIN AND MORE)
NUMBER OF SCREENS
TOTAL NUMBER OF SEATS


FORMAT                                                                GENRE
    Feature length films                                                  Fiction
    Medium length films                                                   Animation
    Short films                                                           Children
    New Media products                                                    Documentary
    Other (specify)                                                       Other (specify)


CANADA FEATURE FILM FUND OBJECTIVE(S) FOR FESTIVAL (AS APPLICABLE)    SCOPE OF THE FESTIVAL
   Reach Canadian audiences                                              Regional
   Showcase Canadian feature length films                                National
   Contribute to the appreciation and awareness of Canadian film         International
   works




                                                                                                TFC0810
Telefilm Canada Festivals Performance Program
Application Form
                                                                                                                                                      Page 4 of 5

                                                     REQUIRED DOCUMENT CHECKLIST
At the time of application, together with this completed application form, the applicant must provide all of the documentation
listed below. Please be advised that during the review of your Festival, the applicant may be required to provide additional
documentation or information. Telefilm Canada reserves the right to request any document or information it deems relevant,
including, but not limited to, any document or information pertinent to the eligibility of the applicant and the Festival.

Please be advised that Telefilm Canada will not act as a depositary or be responsible in any way for the holding or return of
any material submitted at any time in connection with the application or the Festival and such material may be destroyed at
any time.
                                                                                                                                                       FOR TFC
                                                                                                                                      ENCLOSED
                                                                                                                                                       USE ONLY
1. Application form (duly completed and signed)

2. Proposal for the Festival, (maximum 2 pages) including the following:
       How Telefilm Canada’s participation in this Festival will contribute towards increasing audience
        awareness and diversify and/or foster the development of future audiences by showcasing
        Canadian content;
       The core competencies of the festival organizer as they pertain to the success of the Festival;
       Key benchmarks upon which the applicant will measure and report on the success of the Festival.
3. Marketing Plan and detailed promotion and publicity plan.

4. Visibility Plan for the acknowledgement of Telefilm Canada’s participation.

5. Profile of Applicant Company and Key Personnel CVs, including board members as applicable.

6. Budget and financing plan for the Festival, dated, signed and in Telefilm standard format, including a
   declaration of related party transactions (template available on Telefilm’s website at:
   http://www.telefilm.gc.ca/03/37.asp).

7. Co-applicant company’s agreement (as applicable).                                                                                     (N/A     )


8. The following documents are required only if they have been updated or modified since                                                               FOR TFC
                                                                                                                       ENCLOSED         ON FILE
   the applicant company’s last funding application:                                                                                                   USE ONLY
      Incorporation documents for applicant production company(ies) and parent company(ies),
       if applicable, with list of shareholders indicating citizenship and ownership share
   
                                                                         1
       Corporate financial statements for the past three fiscal years
      Shareholder or partner’s agreement (as applicable)
      Canadian Status of Corporation and Corporate Information Affidavit (form available on
       TFC website)



Please be advised that the successful applicant may be required during contracting to provide Telefilm Canada with further
documentation.




1
    The applicant must provide for the last three fiscal years:
       (a) if the request to Telefilm is under $100,000, financial statements *;
       (b) if the request to Telefilm is equal to or above $100,000, audited financial statements.
    * Telefilm reserves its right to require that an independent auditor’s report be submitted, at the organization’s expense, no matter the level of Telefilm’s
    participation in the Festival.

                                                                                                                                                        TFC0810
Telefilm Canada Festivals Performance Program
Application Form
                                                                                                                               Page 5 of 5

                           TELEFILM CANADA IS SUBJECT TO THE ACCESS TO INFORMATION ACT.

                                                        APPLICANT STATEMENTS:

The undersigned authorized representative of the applicant or co-applicant (as applicable) hereby:
        authorizes Telefilm Canada to discuss and disclose any information concerning any aspect of the funding application, the
         Festival, any previously completed festival, the applicant and any related party to the applicant with every entity connected (in
         Telefilm’s opinion) with the funding application, the Festival, any previously completed festival, the applicant and any related
         party to the applicant, including, but not limited to, actual or proposed financial partners, auditors, legal counsel(s), the
         Department of Canadian Heritage, and other governmental entities, (collectively the “Entities”). The applicant further
         authorizes said Entities to discuss and disclose to Telefilm Canada, any information concerning any aspect of the funding
         application, the Festival, any previously completed festival, the applicant and any related party to the applicant;
        authorizes Telefilm Canada to disclose on its website any and all information pertaining to the application and/or Festival.
        agrees to notify Telefilm Canada immediately if and when any changes occur to any of the submitted documents and shall
         provide written details of same;
        declares that the applicant has not entered into any oral or written agreement or side deal that conflicts with any of the
         provisions of this application form, the Festivals Performance Program Guidelines, and applicable Telefilm Canada business
         policies;
        declares that the Festival complies and will continue to comply with the Festivals Performance Program Guidelines, and
         applicable Telefilm Canada business policies;
        has made and shall make full disclosure to Telefilm Canada of any dispute, and actual or potential litigation in connection with
         the Festival;
        declares that all persons specified as being Canadian in the application and all accompanying documentation, are Canadians,
         in accordance with the Investment Canada Act, the Immigration and Refugee Protection Act or the Citizenship Act;
        authorizes Telefilm Canada to reproduce and distribute internally to its employees and subcontractors, all material submitted
         at any time in connection with the Festival, using any medium or support including its internal servers.

The undersigned hereby solemnly declares and warrants that the information and documents submitted for this application
are accurate, true and complete, and makes this solemn declaration knowing that it is of the same force and effect as if made
under oath.

Signature of Applicant :

                                      I am duly authorized


                                      (Please print )
Title:


                                                                     Date:
                                                                                    Y                    M                     D
Signature of co- Applicant:
(as applicable)
                                      I am duly authorized


                                      (Please print )
Title:


                                                                     Date:
                                                                                    Y                    M                     D




                                                                                                                                   TFC0810

								
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