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FOR OFFICE USE ONLY Date Received_________________________

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					                                               FOR OFFICE USE ONLY

                                               Date Received_________________________

                                               Submission No________________________



                      AUSTRALIAN CHILDREN’S TELEVISION FOUNDATION

                PROJECT DEVELOPMENT INVESTMENT – APPLICATION FORM




Applicant Details

If applying as an individual

1.     Name of applicant:_______________________________________________


2.     Address of applicant:_____________________________________________


       _____________________________________________________________________


3.     Telephone details for applicant:

       Work (   )______________ Home(     ) ___________ Fax(   ) _________________

       e-mail: _________________________________________


4.     Applicant ABN:__________________________________________________

If applying as a company

5.     Name of company and ABN:______________________________________________


6.     Company contact:______________________________________________________


7.     Address of registered office_______________________________________________


8.     Contact details:

       Work (   )______________ Home(     ) ___________ Fax(   ) _________________

       e-mail: _________________________________________
9.     Names of company officeholders:

       _____________________________________________________________________


       _____________________________________________________________________

Project details

10.    Project name:__________________________________________________________


11.    Format of proposed project (please indicate most appropriate description of your
       project):

             Telemovie                 TV series (long running)                Feature Film

             Documentary               TV Serial                               Mini Series


12.    Category (please indicate most appropriate description of your project):


             Drama                     Fantasy                                 Adventure

             Science Fiction           Comedy                                  Variety

             Animation


13.    Number of episodes                               Duration per episode


14.    Target age group:               0-5              6-9           10-13              14+


15.    Is project the original work of the applicant?   Yes     No


       If No:

       (a)      Title of original work_______________________________________________

       (b)      Writer/Originator__________________________________________________

       (c)      If work published, give details_______________________________________

                _______________________________________________________________

                _______________________________________________________________

                [Please remember to attach relevant rights/option agreements]
16.   Proposed team (if applicable):


      Executive Producer/s: ________________________________________________



      Producer/s:            ________________________________________________



      Writer/s:              ________________________________________________



      Director/s:            ________________________________________________



      Script Editor/s:       ________________________________________________



      Other (please specify): ________________________________________________


      Please attach the CVs of each proposed member of the team


17.   Proposed production budget:___________________________________________


18.   Have you approached any other Government (State or Commonwealth) funding
      bodies for support for this project? If Yes, please provide details (even if applications
      were unsuccessful):

      _____________________________________________________________________

      _____________________________________________________________________

      _____________________________________________________________________

      _____________________________________________________________________

19.   Has the project been presented to any broadcaster, distributor or agent (both local and
      international)? If yes, please give details, including any copies of agreements, deal
      memos or letters of interest.

      _____________________________________________________________________

      _____________________________________________________________________
20.   Why do you think this project has audience potential in Australia?

      _____________________________________________________________________

      _____________________________________________________________________

      _____________________________________________________________________

      _____________________________________________________________________

      _____________________________________________________________________

      _____________________________________________________________________

21.   Have you previously received development funding from the ACTF.              If yes, please
      provide details (e.g. project title, development stage, amount, year etc):

      _____________________________________________________________________

      _____________________________________________________________________

      _____________________________________________________________________


22.   Does the project contain any indigenous themes, content or storylines ?

      Yes       No

      If yes:

      Please name the indigenous community from which you have based your project/work.

      ________________________________________________________________

      Please provide details of authority/permission to use the indigenous material contained
      in your project.

      _____________________________________________________________________

      _____________________________________________________________________

      _____________________________________________________________________

23.   Stage of development.

      Please detail what the proposed development funding would be used for (ie what is your
      proposed “next stage” of development?).

      _____________________________________________________________________

      _____________________________________________________________________
Development budget and schedule

24.   Details of development funding on this project to date (including by applicant):

                                 Description                      Amount (ex GST)
                                                                         $
           1

           2

           3

           4


                                                        Total



25.   Total development budget for this next stage: $

      Please also attach a detailed development budget.



26.   Details of funds requested from ACTF:

                                 Description                      Amount (ex GST)
                                                                         $
           1

           2

           3

           4


                                                        Total


27.   Have you sought/ obtained matched development funding from another source? Is so,
      give details:

      _____________________________________________________________________

      _____________________________________________________________________
28.      Proposed development schedule

         _____________________________________________________________________

         _____________________________________________________________________

         _____________________________________________________________________

         _____________________________________________________________________

         _____________________________________________________________________


      29. Please attach any producers, writers and/or script editors’ notes on the proposed
          development.
Checklist


 Please check that this submission includes TWO copies of:

 • 4-5 line synopsis of project;

 • one page synopsis of project;

 • existing development materials;

 • a CV for the applicant and any attached creative team; and

 • all relevant documentation such as rights/option agreements and consents from
 indigenous communities;

 • full development budget;

 • producers, writers and/or script editors’ notes on the proposed development.



Declaration by applicant

I warrant that the information given in this application is true and correct and understand that I
may be required to provide evidence of this information. I undertake to provide it if so requested.


If a person:


_________________________                          _________________________
Signature of primary applicant                     Name of primary applicant


Date:_____________


If a company:

_________________________                          _________________________
Signature of director                              Signature of director/secretary


_________________________                          _________________________
Name of director                                   Name of director/secretary


Date:_____________
                                              DEED OF RELEASE


TITLE OF PROJECT SUBMITTED:...........................................................................................


DATE:.............................




To:       Australian Children’s Television Foundation (ACTF)
          ACN 005 986 952


1.        *I warrant that I own the underlying rights to this project, and have the right to develop
          the project in the manner described in the attached application form

OR
          *I warrant that I have a licence to use the underlying rights for this project from the
          owner or owners of those rights, and have the right to develop the project in the manner
          described in the attached application form

          * Strike out whichever is not applicable.


2.        I acknowledge that the ACTF regularly receives submissions for programs as well as
          internally generating its own program ideas and that there is a chance that my project
          may have similarities to existing or future projects in which the ACTF may be involved.
          In this context, I agree that I will not make any accusations of plagiarism or breach of
          copyright or confidentiality against the ACTF. I also agree not to request the ACTF
          determine the originality of any program.

3.        I understand that the ACTF may provide materials submitted by me to external
          assessors, and may include details of the project, the applicant, the creative team
          and a brief synopsis of the project in its documents and publications.

4.        I understand that the ACTF will rely on the information in the attached application form
          and in this deed. I will keep the ACTF indemnified against all actions, suits,
          proceedings, claims or demands made against it by reason of any breach of the
          warranties or acknowledgements made in this deed or by reason of any of the
          information in the application form being untrue, incorrect or inaccurate.

5.        I have retained a copy of all material submitted and the ACTF shall not be responsible
          for the preservation or return of the material.
If a person:


_________________________        _________________________
Signature of primary applicant   Signature of witness


_________________________        _________________________
Name of primary applicant        Name of witness


Date:____________________



If a company:


_________________________        _________________________
Signature of director            Signature of director/secretary


_________________________        _________________________
Name of director                 Name of director/secretary



Date:____________________

				
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Description: FOR OFFICE USE ONLY Date Received_________________________ ...