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Applicants to the Low Budget Independent Feature Film Assistance

VIEWS: 13 PAGES: 3

  • pg 1
									                                    Feature Length Theatrical Documentary Fund

                                    Application Form 2005/2006


                                                                                                                               Page 1 of 3

Applicants should be familiar with the Feature Length Theatrical Documentary Guidelines of The Documentary Channel and
the National Film Board of Canada (NFB) 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
applicants prior to submission to the NFB. Incomplete Applications will be returned to the applicant. You must send this
Application form and all relevant documentation to the e-mail address indicated in the Guidelines. The original signed copy of
this Application form and of the Submission Agreement must also be sent by mail to the address indicated in the Guidelines.


Current title of project                                              Previous title(s) of project

Legal name of applicant’s production company                          Legal name of co-applicant’s production company(ies)
                                                                      (as applicable)

Address                                                               Address

City                      Province                      Postal Code       City             Province      Country       Postal Code

Telephone                            Fax                              Telephone                          Fax
(   )     -                          (   )      -                     (   )   -                          (   )     -
E-mail                                                                E-mail
Web Address                                                           Web Address
Contact for this file


Project Participants                Last Name                First Name                    Citizenship
Director
Producer
Co-producer
Executive producer
Production manager
Scriptwriter(s)
Researcher
Story consultant
Director of photography
Editor
Music composer
Lead performer/narrator
Lead performer/narrator
Distributor


Has this project ever been submitted to the NFB ?                           Yes      No
If it received funding, please provide the following information:
AMOUNT                     DATE OF CONTRACT                                AT WHAT STAGE                  APPLICATION NUMBER

                                Y                   M            D

Has this project ever been submitted to the Documentary                     Yes      No
Channel?
If it received funding, please provide the following information:
AMOUNT                     DATE OF CONTRACT                                AT WHAT STAGE                  APPLICATION NUMBER

                                Y                   M            D
                     Feature Length Theatrical Documentary Fund

                     Application Form 2005/2006
                                                                                                                              Page 2 of 3




DUBBED VERSION         ORIGINAL VERSION                       SUBTITLED VERSION          SHOOTING FORMAT
    English                English                                English                    Film                             mm
    French                 French                                 French                     Video                            (specify)
    Other                  Double shooting                        Other
                           Other
                                                                                         DELIVERY FORMAT / DATE
     CLOSED CAPTIONED FOR THE HEARING-IMPAIRED
                                                                                         DURATION (IN MINUTES)




Document Checklists
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 project, the applicant may be required to provide additional document ation or
information. The NFB and The Documentary Channel reserve the right to request any document or information deemed relevant,
including, but not limited to any document or information pertinent to the eligibility of the applicant and the project.

Required for all applications:                                                                                                 Enclosed
1.       C.V.’s for all key personnel, as applicable

         Director
         Producer
         Co-producer
         Executive producer
         Production manager
         Scriptwriter(s)
         Researcher
         Story consultant
         Director of photography
         Editor
         Music composer
         Lead performer/narrator
         Lead performer/narrator
2.       Financing Structure and details of all confirmed and projected financing, whether or not included in the financial
         structure, evidencing the terms, conditions and value of the financial contributions.
3.       Copy of creative materials: treatment and any other available material

4.       Production and post production schedule:
            date and number of photography days
            location of all photography (cities and countries are sufficient)
            commencement and completion of principal photography dates (if applicable)
            expected rough cut, fine cut, delivery and final audited cost dates.

5.       Production budget (using Telefilm standard budget template)

6.       Standard Submission Agreement as provided by the NFB and The Documentary Channel


All material submitted with the application form will be retained by the NFB.

The National Film Board of Canada is subject to the Access to Information Act.
                    Feature Length Theatrical Documentary Fund

                    Application Form 2005/2006
                                                                                                                             Page 3 of 3




APPLICANT PRODUCTION COMPANY STATEMENTS

The undersigned, authorized representative of the applicant hereby:

   authorizes the NFB and the Documentary Channel to discuss and disclose any information concerning any aspect of the funding
    application, the project, any previously completed project, the applicant and any related party to the applicant, with every entity
    connected (in the NFB’s or Documentary Channel’s opinion) with the funding application, the project, any previously completed
    project, the applicant and any related party to the applicant, including, but not limited to, actual or proposed financial partners,
    corporate and/or completion guarantors, interim financiers, auditors, legal counsels, the Canadian Television Fund, the Department
    of Canadian Heritage, CAVCO, CRTC, and other governmental entities (collectively the “Entities”). The applicant further
    authorizes said Entities to discuss and disclose to the NFB or the Documentary Channel any information concerning any aspect of
    the funding application, the project, any previously completed project, the applicant and any related party to the applicant;


   agrees to notify the NFB and the Documentary Channel immediately if and when any changes occur to any of the submitted
    documents and shall provide written details of same;


   has made and shall make without delay full disclosure to the NFB and the Documentary Channel of any dispute, actual or potential
    litigation in connection with the project;

   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.

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.
Producer’s last name              First name                    Signature of producer                          Date

                                                                                                              Y          M         D
Canadian co-producer’s last name     First name                       Signature of Canadian co-
                                                                      producer (as applicable)                        Date

                                                                                                              Y          M         D

								
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