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Title of Project:

Project can include plays, musicals, dance, multi-disciplinary experimental work.

Applicant Name:
Applicant Disciplines:

Writers, Actors, Directors, Producers
*Special consideration will be given to multi-disciplinary applicants

Applicant Union Affiliation(s):

Applicants must be a member of a Canadian professional arts guild or union

For further information regarding this application and project listed above, contact:

Telephone:
Address:
Email:
Website URL (if applicable):

PLEASE ANSWER THE FOLLOWING QUESTIONS

1.Please provide a synopsis of your project. (200 max)

2.How will these use these funds contribute to your production? (150 max)

3.How do you define yourself as an emerging or transitioning artist? (100 max)

4.If you are selected for the CCA you will be matched with a mentor to assist you with one aspect of your project. Please indicate what aspect you feel a mentor would be most helpful to you at this stage and why? (100 max)

1. PROJECT INFORMATION

PROJECT

Title of Project:
Genre:
Estimated Production Budget: / $
Project Length

CONCEPT OUTLINE (150 Words Max):

PRODUCTION SCHEDULE:
NOTE: MUST BE COMPLETED WITHIN THE CALENDER YEAR

Rehearsal Dates:
Dress Rehearsal Date(s):
Performance Date(s):

KEY CREATIVES:

*please fill in or addapplicable positions

Position / Name / Confirmed?
Y/N / List recent credits and any awards:
Executive Producer
Producer
Writer
Director
Dramaturge
Performer(s)

BUDGET:

* please fill in or addapplicable categories

Account / Category / Days / Rate / TOTAL
01 / Executive Producer / $0
02 / Producer / $0
03 / Writer(s) / $0
04 / Director / $0
05 / Actor(s) / $0
06 / Dramaturge / $0
07 / Stage Manager / $0
08 / Ass Stage Manager / $0
09 / Set Design / $0
10 / Lighting Design / $0
11 / WardrobeDesign / $0
12 / Theatre/Space Rental / $0
13 / Programs/Printed Materials / $0
14 / Props / $0
15 / Wardrobe Supplies / $0
16 / Music/Sound Effect / $0
17 / Video Footage Effects / $0
TOTAL / $0

FINANCING:

Do you have any confirmed financing to date for this project?
* If yes, complete the chart below / Yes / No
Source / Amount ($)
$0
$0
$0
$0
TOTAL / $0
Required Documents (Electronic Submission- ) / Emailed
  1. Complete Application Form, in *.DOC format

  1. Cover Letter

  1. Applicant Resume

  1. Application Project Writing Sample (no more then 6 pages)

  1. A letter of recommendation from a film or theatre professional

* No attachments, other than the documents listed above, will be accepted.

D. Acknowledgement, Disclaimer and Sign-Off

Please ensure that your application meets the requirements of the Cayle Chenrin Award Guidelines.

This application form and all required documents must be completed in full and emailedto be considered.

The applicants hereby warrant that the information provided in this Application Form is complete and accurate and that the signatory has the full authority to submit this application to the Cayle Chernin Award.

The applicant hereby authorizes the Cayle Chernin Award to communicate any information in this application with any third party indicated in this application as a proposed or committed source of financing for this project.

NOTE: The applicant hereby acknowledges that the applicant or a representative will attend the Cayle Chernin Awards in May 2018, where the winning recipients will be announced.Applicants are encouraged to raise awareness for the CCA. In the interests of reaching and informing the general public of the CCA's activities and events, it is hereby acknowledged that award recipients will be required to further promote the CCA in the press and media, in line with the expectations provided by the Award Recipient Agreement.

Applicant Signature: / Date:


January 2018