Nisimazine KVIFF 2017 Application Form
Film Journalism Workshop
July 1-8, 2017
Karlovy Vary, Czech Republic

*IMPORTANT: Eligible applications should be accompanied by evidence of your previous journalistic works (minimum 1 article in English or translated into English /6 photographs/2 links to videos) and one passport-style photograph.
Please send all material under the subject line "LAST NAME Nisimazine VIS Application" to nisimasaparis@gmail.com.

Please complete this form in English.


DECLARATION AND CONDITIONS

(x) I have read and understood the call for participants, and give my agreement for all listed terms and conditions therein.
(x) I agree that my personal data given in this application form may be available to other participants.
(x) I declare my availability for the entire duration of the event.
(x) I agree that the rights of my articles/pictures will belong to NISI MASA.

First Name(s)
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Surname
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Untitled Section
Date of Birth (dd/mm/yy)
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Sex
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Nationality
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Private Tel (with country dialing code)
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E-mail
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Private postal address
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Member of NISI MASA?
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Name and Address of Organisation
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I am applying as
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Field(s) of Activity (Works, studies, etc.)
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What is your motivation for taking part in the “Nisimazine KVIFF" Workshop?
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What are your personal expectations?
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Could you present us some ideas of articles/pictures/videos you would like to make for the Nisimazine workshop?
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Have you ever participated in a NISI MASA event before?
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How did you discover our activities?
Please sign your name to declare you agree with the declaration and conditions
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