Actor Registration- Time Bank Promo
This form is for interested actors with disabilities to register for an opportunity to appear in a promotional video for the Good Neighbors Time Bank- highliting the benefits of time banking.  The Good Neighbors Time Bank is supported by a generous grant from the Pennsylvania Developmental Disabilities Council
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Email *
Actor’s Name *
Actor’s cell phone number *
Actor’s email address *
Additional contact person’s name
Additional contact cell phone
Additional contact email address
Age of Actor *
Actor’s gender
Clear selection
Does the actor have any film or stage experience? *
Is the Actor willing to sign an Image Use Release the day of filming *
Does the Actor agree to the $150.00 stipend to be paid via gift card? *
Is the Actor available for filming on August 16th in the Pottstown, PA area? *
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