Regional Investment Fund for England (RIFE)
PRODUCTION & DEVELOPMENT – Large Awards
Application Form / GIFTS ref:………………………………..……
Please ensure that you read the Large Award Guidelines before filling in this form. We review our application form and guidance notes from time to time, please visit our website to check that you have the most up to date version.
If you send us an old form, we may be unable to consider it and will send you a new one to complete.
Applicant DetailsName of Applicant / Main Contact:
Organisation Name:
Have you had a 1 to 1 with a Screen South Executive about this application? / Yes / No
If yes please give - / Location: / Date: / Executive:
Full Postal Address:
Postcode: / County: / Local Authority:
Telephone: / Mobile: / Fax:
E-mail: / Website:
Do you have any special access needs? / Yes / No
If yes please specify:
If you’re an organisation what is your main area of activity?Please tick all those relevant:
Archive
Broadcast
Charity
Co-Financier
Community Organisation / Education/Training Organisation
Facilities House/Studio
Festival
Full-time Cinema
Library / Museum
Part-time Cinema
Production Company
Reader
Other - please specify:
What is the legal status of your organisation? Please tick one:
Charity Legally Constituted Partnership Local Authority / Other Public Sector Body
Private Company / University/college/school
Other – please specify:
Is your company VAT registered? / Yes / No
Company Registration Number: / When was your company set up? (month/year)
What is your company’s turnover for the current financial year? / £
Does your organisation have public liability insurance? / Yes / Please specify value - £ / No
Programme area(Please tick all those relevant)
Development
Pre Production
Production / Post Production
Marketing Development: Distribution
Marketing Development: Promotion
Genre of Project (Please tick all those relevant)
Action/Adventure
Animation
Comedy
Costume/Period Drama
Documentary/Factual / Drama
Family/Children’s
Horror
Musical
Romance / Sci-fi
Thriller
War
Western
Other - please specify:
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Project Details(please use further pages if necessary)Project Title:
Proposed Duration:
Tell us about your project (Minimum 300 words). This is your chance to sell your project to us. Include Key activities and your delivery plan. Indicate all income streams - current and future.
What element(s) of your project are you applying to Screen South for?
When do you expect this part of your project to start? (dd/mm/yy)
When do you expect this part of your project to finish? (dd/mm/yy)
Project Cost & Income / (please attach a full working budget and cashflow for the elements you are applying for, and also a summary budget for the entire project)What is the entire project budget? (inc.VAT):
/ £Total Cost of the elements you are applying to Screen South for (inc.VAT):
/ £Amount requested fromScreen South (inc.VAT):
/ £What percentage of the total cost of these elements are you applying for?
/ %Are these costs based on: / Please selectAn initial estimateDetailed costingA pre-tender estimate or equivalentA quotation / Other – please specify:
Please clearly identify below all sources of partnership income for this part of your project. (This should ideally be 20% of the total cost):
Area of Funding / Amount Applied for / Amount Approved / Amount Received / Total / % of total
Local Authority Funding
European Regional Development Fund
European Social Fund
Other Public Sector Funding
Charitable Funding
Other Income
Private Sector Funding
Help in Kind
Application to Screen South
Shortfall
Total Income (same as total cost):
We would like to know how accurate your figures are likely to be. We may contact your investors for more information.
Questions about your project…
How will you ensure delivery of the project to the highest standard?
How will you promote your project to buyers, commissioners and/or funders in the marketplace?
Please outline how this project will further your personal or company ambitions/objectives:
How will you market your project and what market/audience are you aiming at?
What similar projects have you or your team successfully delivered?
Questions about your project… (Cont.)How will you monitor the progress of the project? Define the outputs and deliverables for evaluating its success:
Outline the partnerships you already have in place and also what partnerships you are seeking.Give details of how they will be involved in the planning and/or delivery of this project.
Partnerships in place:
Partnerships seeking:
What do you think the public value of your project will be -why should you be awarded Public Funding?
Previous Lottery FundingHave you ever applied for lottery funding before? (Including Screen South) / No
Yes - If yes please give information below:
Organisation Applied to? / Project Title / Reference Number / Project Type e.g. P&D / Amount applied for / Amount awarded / Current Status of Award e.g. completed
Please selectDevelopmentPreproductionProductionPost ProductionMarketingFesitval AttendanceDistributionTrainingOther / £ / £ / Please selectPendingActiveCompletedWithdrawnStopped
Please selectDevelopmentPreproductionProductionPost ProductionMarketingFesitval AttendanceDistributionTrainingOther / £ / £ / Please selectPendingActiveCompletedWithdrawnStopped
Please selectDevelopmentPreproductionProductionPost ProductionMarketingFesitval AttendanceDistributionTrainingOther / £ / £ / Please selectPendingActiveCompletedWithdrawnStopped
Please selectDevelopmentPreproductionProductionPost ProductionMarketingFesitval AttendanceDistributionTrainingOther / £ / £ / Please selectPendingActiveCompletedWithdrawnStopped
Please selectDevelopmentPreproductionProductionPost ProductionMarketingFesitval AttendanceDistributionTrainingOther / £ / £ / Please selectPendingActiveCompletedWithdrawnStopped
Please selectDevelopmentPreproductionProductionPost ProductionMarketingFesitval AttendanceDistributionTrainingOther / £ / £ / Please selectPendingActiveCompletedWithdrawnStopped
Please selectDevelopmentPreproductionProductionPost ProductionMarketingFesitval AttendanceDistributionTrainingOther / £ / £ / Please selectPendingActiveCompletedWithdrawnStopped
£ / £ / Please selectPendingActiveCompletedWithdrawnStopped
Project Diversity Monitoring / (This section is to help us understand the nature of your project and any access and inclusion opportunities that might be offered by it)
What age of intended participants is your project directed at?(You may tick more than one option if relevant)
Children (Under 14) / Young People (14-18) / Young Adult (19-26) / Adult (Over 26)
Is your project directed at, or of particular relevance to, people from a specific ethnic background? Please tick all backgrounds relevant: (The lottery distributors have agreed with the DCMS that all applications for lottery funding will record whether the people who will benefit from the project are entirely or mainly from ethnic-minority communities.)
A: White / B: Mixed / C: Asian or Asian British
White British / White and Black Caribbean / Indian
White Irish / White and Black African / Pakistani
Any other White Background / White & Asian / Bangladeshi
Any other Mixed Background / Any other Asian Background
D: Black or Black British / E: Chinese or Other Ethnic group
Caribbean / Chinese
African / Any other Ethnic Group
Any other Black Background
Is your project directed at, or of particular relevance to, people with disabilities?
Hearing impaired / Visual impaired / Other physical impaired
Mental disability / All types of disability / No
If your project involves work with children, young people or with vulnerable adults, are all staff covered by legal requirements? (For example, CRB check.)
Yes (Please include a copy of your organisation’s child protection policy) / No
CHECKLIST
/ Individual / OrganisationThis checklist will help you make sure that you are sending us a complete application.
Please note: if you do not send all the information we require, we will not process your application.
Tick the boxes to confirm that:
The main contact - has signed the declaration
A senior contact from your organisation (not the main contact) has signed the declaration / N/A
AND you must have enclosed:
A copy of your Constitution, Articles of Association or Memorandum and Articles / N/A
A copy of your most recent audited End of Year Accounts / N/A
Child Protection Policy for the Organisation (if relevant) / N/A
Equal Opportunities Policy for the Organisation / N/A
2 Forms of Proof of Address - less than three months old / N/A
A one page summary of your project to date
A full treatment of your project (minimum 5 pages for documentary)
Schedule of Proposed Activities
A Full Budget for the Planned Activities
A Cashflow for the Planned Activities
A summary budget for the entire project
CV's of Key Personnel
Relevant AV for key team (i.e. showreel or examples of previous work)
Relevant AV for project (i.e. promo, trailer, rough-cut or finished film)
Have completed the Equal Opportunities Additional Information (final page of this application form)
If applying for Feature Film Development or Production you have enclosed an unbound screenplay
If applying for Feature Film PostProduction you have enclosed a first cut (on DVD)
If applying for Marketing Development (Distribution or Promotion)you have enclosed the final film (DVD)
If applying for Marketing Development: Distribution you have enclosed evidence of sales agent / film festival interest
If applying forMarketing Development: Promotion you have encloseda festival and marketingplan
Freedom of Information Act
The Freedom of Information Act 2000 gives members of the public the right to request information held by Screen South. This includes information held in relation to applications to Screen South’s various funding programmes or schemes. Therefore if you choose to apply to Screen South you should be aware that the information you supply, either in whole or in part, may be disclosed under the Freedom of Information Act.
Data Protection Act
Part or all of the information you give us will be held on computer and used for statistical purposes. It will also be used for the administration of applications and awards. We may provide copies of the information in confidence to individuals or organisations who are helping us assess applications or monitor funding and may also be shared in connection with these purposes with other companies in the UK Film Council group of companies.
If you would like to be added to the Screen South Mailing List and Newsletter please tick the box
If you would not like to be added to the Screen South Mailing List and Newsletter please tick the box
Fraud
Screen South will take legal action to recover funds from an applicant who has provided fraudulent information in the application.
Declaration
Are you aware of any personal or professional relationship with any staff or board member of Screen South or the UK Film Council? (If yes, who are they?)No / Yes…………………………………………………………..
When you fill in this section, please print in BLOCK CAPITALS and include the full names and positions of those people signing. At least two members of the organisation must sign the application form. One of these people should be the main contact, and the other should be a chair or another member of your organisation’s management.
- The signature on the application form must be original.
- We cannot accept photocopied or faxed signatures.
We have read the Screen South ‘RIFE Large Award guidelines’ and the ‘RIFE More Information’ document.
The project described in the application falls within our powers of the constitution or Memorandum and Articles of Association. We have the power to accept any award offered, depending on the conditions shown, and to repay the award if we do not meet the conditions.
We confirm that the information we have given is true and we have answered all the questions on the form. We will let you know immediately if any of the information we have provided changes.
Main Contact / Second Signature (Organisations Only)
Name / Name
Position / Position
Signature / Signature
Date / Date
Sending Your Application
Please send completed applications and supporting documentation to:
RIFE Large Awards
Screen South
The Wedge
75-81 Tontine Street
Folkestone
Kent
CT20 1JR / Upon receipt your application will be logged and you will receive an acknowledgement in the form of an email containing a unique reference number which will be used in all future correspondence regarding your application. Please ensure that you have provided us with your correct email address.
Please do not bind or staple your application materials (please collate and use clips).
WE CAN NOT ACCEPT FAXED, PHOTOCOPIED OR EMAILED APPLICATION FORMS.
WE WILL NOT ACCEPT LATE APPLICATIONS.
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Equal Opportunities Monitoring FormWe are committed to pursuing equal opportunity. Monitoring applicants and applications is one way of helping ensure that there is no discrimination in the way applications are assessed. The information you provide on gender, ethnic origin and disability will be used for monitoring purpose only. This form will be separated from your application upon receipt and the diversity information it contains will not influence your application in any way.
Please note you will need to return this form as part of your application, providing any of the diversity information requested is optional.
If you are successful in obtaining an award with this application Screen South will require a diversity report, this will include diversity information about all individuals from your organisation involved in the project. This will be due once the project is complete.
Gender of Main Applicant:
Male / Female / Do not wish to disclose
Ethnic Group of Main Applicant:
Chose ONE section from A to F, then tick the appropriate box to indicate your cultural background:
A: White / B: Mixed / C: Asian or Asian British
White British / White and Black Caribbean / Indian
White Irish / White and Black African / Pakistani
Any other White Background / White & Asian / Bangladeshi
Any other Mixed Background / Any other Asian Background
D: Black or Black British / E: Chinese or Other Ethnic Group / F:
Caribbean / Chinese / Do not wish to disclose
African / Any other Ethnic Group
Any other Black Background
Disability of Main Applicant:
Are you registered as disabled?
Yes / No / Do not wish to disclose
Please provide diversity information for every person on the project team who will be involved:
For example if there are three women on your team – please insert ‘3’ next to female.
Gender of Project Team members:
0 Male / 0 Female / Do not wish to disclose
Ethnic Group of Project Team members :
Please insert numbers to indicate the cultural background of your team members (i.e. ‘2 White British…’)
A: White / B: Mixed / C: Asian or Asian British
0 White British / 0 White and Black Caribbean / 0 Indian
0 White Irish / 0 White and Black African / 0 Pakistani
0 Any other White Background / 0 White & Asian / 0 Bangladeshi
0 Any other Mixed Background / 0 Any other Asian Background
D: Black or Black British / E: Chinese or Other Ethnic Group / F:
0 Caribbean / 0 Chinese / Do not wish to disclose
0 African / 0 Any other Ethnic Group
0 Any other Black Background
Disability of Project Team members:
Please insert numbers to indicate whether members of your project team are registered as disabled?
0 Yes / 0 No / Do not wish to disclose
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