FILM STUDENT INFORMATION FORM

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This form is required every semester to activate your film equipment checkout privileges.

Name *

Pronoun (only if you would like to share)

E-mail *

K Number *

Pipeline E-mail Address *

Phone Number *

Address *

City *

Zip Code *

CURRENT SBCC FILM CLASSES *

Select all that apply

FP 170 - Cinematography 1

FP 175 - Film And Video Production I

FP 178 - Documentary Filmmaking

FP 181 - Production Sound for Film/TV

FP 185 - Directing For The Camera I

FP 270 - Cinematography II

FP 275 - Production II: Narrative

FP 281 - Post-Production Sound

FP 294 - Capstone

Required

PREVIOUS SBCC FILM CLASSES *

List only SBCC film classes taken -- answer N/A if you have not taken any.

QUESTIONS AND COMMENTS

Your questions and comments will be answered by email. Feel free to contact your Lab Teaching Assistant Chien-ei at 805.897.3569.

READ & SIGN

I have read and understand the Checkout Rules. I agree to abide by the rules. I agree to reschedule if I am late, and I agree to pay for the replacement or repairs of any equipment lost or damaged while checked out to me.

Digital Signature *

Date *

YYYY

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