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Media Project Request
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Email *
Client Information
Client Name
Contact Name First and Last *
Contact email address *
Contact phone: (For Internal office use only between the Serge leadership and E.A Media Productions)
Client is Serge employee *
Client relationship with Serge *( Give a brief synopsis of ministry / work with Serge) *
Serge Team Name (For Serge Employee)
Team Leader Name (For Serge Employee)
Are there any security concerns involved with this project? If so, please explain.
Project Background
Please give a brief synopsis of the project/program. What problems is it trying to address, what issues to highlight and do you have any beneficiaries or statistics that can speak to its effectiveness?

What is the Purpose of the Video? *
What do you want the video to achieve?*  Explain.
If Fundraising, what is the target amount to raise?
If Fundraising, Is this video associated with a Serge Project? (Please ask your Team Leader or review the Serge Field Manual for Special Projects to see if a project application is required) *
What are the daily activities? Would there be action to film other than interviews?
What B-roll can be photographed / filmed to help tell the story visually?
Who would be the main interview or subject(s)?
Describe your target audience.
What do you want / expect the audience to do after watching the end product?
Where will the video be seen or hosted?
Provide a description of content and any key messages which you want the video / photos to get across.
What is the target video length?
What style and format do you want the video to have?
If other than options above,  please describe
Describe the overall tone of the end product (Video/photos).
What production elements are required?
How many locations will we need to cover in shooting footage and photos? Please list the locations and explain.
Will clearance and permits be required to shoot in those locations?  Explain.
If your project requires aerial footage please check all that apply:
Do you have a sample video or link online that is similar to what you want to create?
Date final media product(s) is/are needed
MM
/
DD
/
YYYY
What is the development timeline?
When can the planning and scripting start?
What format would you like to receive the final product in? MV4, MP4, MOV, JPG, etc.
The filming and production will be free of charge. Our time planning, shooting and post - production will be covered by our existing salary with Serge. We ask that the client provide reimbursement for:
Travel costs
Accommodation
Permits to location and on location
Food and beverage
Assistance on location when shooting. (Translation if applicable, and equipment mobility, etc.)
 Client in agreement to facilitate the above productions items:
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