Film Industry Welfare Trusts Staple recent
ACTOR PREPARES passport size
The School For Actors photograph.
nd
2 Floor, Film Industry Welfare Trust House, next to Ajivasan hall
Near SNDT Womens College, Juhu Road, Santacruz [W]
Mumbai 400 049
e-mail:
[email protected] Phone: 2660 6180 /2660 5659/652 61232: Toll Free: 1800 209 1231
Please fill in this form in neat handwriting / or type. Please be precise & factual.
Send in the form to above mentioned address with a Demand Draft of Rs. 250/- payable at
MUMBAI, in favour of ACTOR PREPARES.
PERSONAL INFORMATION
NAME (IN FULL BLOCK LETTERS)
Mr./ Mrs./ Ms.
Important note: The name mentioned above will be printed on your Diploma.
PRESENT ADDRESS:
City: Pin Code: State:
Country:
Email:
Tel. Home: Mobile:
Fathers Name:
Mothers Name:
DATE OF BIRTH:
Day: Month: Year: Age:
MARITAL STATUS: Married Unmarried
(tick whichever applicable)
No. of children
nd
Film Industry Welfare Trusts Actor Prepares, 2 Floor, Film Industry Welfare Trust House, next to Ajivasan 1
hall, Near SNDT Womens College, Juhu Road, Santacruz [W], Mumbai 400 049 www.actorprepares.net
In case of emergency,
notify [next of kin]
NAME & ADDRESS:
Tel. Home: Business: Mobile:
EDUCATION:
Higher Secondary Graduate Post Graduate (tick whichever applicable)
Other educational qualification [please specify]:
Final year of study: Board/University:
Percentage of Principal
Marks obtained: Subjects:
[Minimum requirement is 10+2. This requirement could however be relaxed for exceptionally
talented writers.]
EMPLOYMENT HISTORY:
What is your current occupation? Studying Employed
(tick whichever applicable)
In case employed, then please give details of your most recent employment:
Date of Employment:
Employers Name & Address:
Full Time employment Part Time employment (tick whichever applicable)
Position Duration: Annual Income:
Held:
ARE YOU INVOLVED WITH THE PERFORMING ARTS / ENTERTAINMENT INDUSTRY?
Yes No (tick whichever applicable)
IF YES THEN IN WHAT CAPACITY:
HOW DID YOU KNOW ABOUT WRITER PREPARES
(tick whichever applicable)
Friends & Relatives
Actor Prepares Web page
Media/Editorial/Advertisement
Promotional Sms/Email
Other sources [please specify ]
WRITING EXPERIENCE
Mention your previous experience as a writer:
ADDITIONAL INFORMATION
Previous study/training in Theatre/Dance/Music/Visual Arts/Other Skills:
Explain briefly why you want to be a writer and your plans after training:
KNOWLEDGE OF LANGUAGES:
Mother tongue:
Languages spoken:
Languages read:
[Note: Medium of teaching will be Hindi and English]
Are you a citizen of India? Yes No
(Tick whichever applicable)
If NO then what is your nationality? :
Passport Details
Passport #: D.O.I.: D.O.E.:
SIGNATURE:
PLACE:
DATE:
Course start date and year
you wish to apply for:
Please attach the following with your application form:
1. Xerox of your valid passport [in case of overseas students]
2. School leaving certificate / copy of your passport stating your date of birth.
3. Medical fitness Certificate.
SCREENING EXERCISE
Please fill the details below as instructed to the best of your abilities.
The below exercise will be used to screen applications post which only the selected
applicants will be offered admission.
Applicants name:
Question 1: In NOT MORE THAN 100 WORDS, write a story idea for a feature film.
Tips: Choose an idea that is close to your heart or something you would be excited to write
about. Also, it should be (according to you) universally appealing.
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