British Columbia Film Foundation

Daryl Duke & William Vince Scholarship Program /Application Form 2016-2017

Applications accepted from:Date Received: ______/______/______
March 30, 2016– May 15, 2016(to be completed by Creative BC)

Name / Program Name
Company (if applicable) / Institution
Contact Person
Permanent Address / Permanent Address
City, Province / Postal Code / City, Province / Postal Code
Telephone / Fax / Telephone / Fax
Email / Website / Contact Email / Website

APPLICANT INFORMATIONPROGRAM FOR WHICH SCHOLARSHIP IS
BEING REQUESTED

PROGRAM INFORMATION:

Primary Discipline: (e.g. writing, directing):______

Program Dates:______

Please provide a brief description (maximum 140 characters) of the program.
______

2225 WEST BROADWAY STREETTEL + 1 604-736 7997DARYL DUKE & WILLIAM VINCE SCHOLARSHIP PROGRAM 2016 -2017
VANCOUVER, BC CANADA V6K

RECENT EDUCATION/TRAINING HISTORY(please attach your resume as well)

Institution
(and location) / Program / Dates Attended / Diploma/
Degree Held / Level Achieved

FINANCIAL INFORMATION / BUDGET BREAKDOWN

ITEM / BUDGET
Tuition
Living Expenses (monthly)
Accommodation/Rent (monthly)
Equipment/Books/Supplies
Other (Please Specify)
Total

FINANCING PLAN (FOR LIVING AND EDUCATION EXPENSES)

SOURCE / AMOUNT / Confirmed/Unconfirmed
Daryl Duke or William Vince Scholarship / $10,000(maximum) / Unconfirmed
Applicant Contribution
Other Government Funding (please specify)
Other Private Funding (please specify)
Total

CHECKLIST: (Please ensure your application includes the following information)

Application Form – signed and completed.

A Mission Statement - outline your career goals and how attending the chosen
educational program will help you reach these goals (1-2 pages).

Portfolio – see program guidelines for specific portfolio requirements.

Resume – outline your educational and work history and list of professional credits.

Two letters of recommendation – from previous teachers and/or employers in your field.

Syllabus – outline your course of study (maximum of 5 pages).

Letter of acceptance – from the institution you propose to attend (if available).

APPLICATION FORMAT:

All printed support materials should be prepared in black type on single-sided 8-1/2 x 11 inch white bond paper, suitable for photocopying. No card stock or laminated materials.
Do not staple or bind submissions and no vinyl binders. Paper clip documents together and place the entire package in a clearly marked envelope.
Email submissions can be sent to: . Please type “Daryl Duke & William Vince Scholarship 2016-17” as the subject heading.
Applications should be saved as one or two PDFs maximum. Please DO NOTsend multiple attachments or folders with multiple documents. Please do not send documents through share filming programs such as DropBox or YouSendIt.

PLEASE SEND PACKAGES TO:

British Columbia Film Foundation
Attn: Daryl Duke & William Vince Scholarship Program
2225 West Broadway
Vancouver, BC V6K 2E4

The application form and all supporting materials must be received by the British Columbia
Film Foundation no later than 4:30 pm on May 15, 2016. Late submissions will not be considered.

DECLARATION:

I hereby declare and warrant that, to the best of my knowledge, the information contained herein is true and complete and I authorize the British Columbia Film Foundation to contact sources necessary to verify the contents of this application and supporting documents. I also agree to provide any additional documentation that is requested by the British Columbia Film Foundation in order to complete the analysis of my application in a timely manner.

___

SignatureTitle
___
Print NameDate

2225 WEST BROADWAY STREETTEL + 1 604-736 7997DARYL DUKE & WILLIAM VINCE SCHOLARSHIP PROGRAM 2016 -2017
VANCOUVER, BC CANADA V6K