2019 Diverse Voices in Docs Application Form
Application deadline: November 1, 2018. Questions? Email DVID@Kartemquin.com.
First Name *
Last Name *
Street address *
Street address 2
City *
State (NOTE: This fellowship is for Midwest-based filmmakers. Please use the "Other" if you feel you have a residency situation that requires additional explanation.) *
Zip *
Phone *
Email *
Website (optional)
Work sample #1 *
Work sample #2
How do you identify yourself? *
Please check one or more below
Required
Please list your relevant documentary experience. Include specific skills or experience you feel you would bring to the cohort. *
DVID applicants are required to have played a principal role in a completed production (producer, writer, director, editor, etc.) and have experience or work history that demonstrates their commitment to social issue documentary.
In no more than 100 words, please provide a short bio about yourself. *
You might want to write this in a word doc, and copy and paste in here when ready!
Please provide a headshot *
Required
Please provide you social handles (Facebook, Twitter, Instagram) *
Do you give permission to Kartemquin to tag and/or use your social media handles for promotional purposes if you are selected for this fellowship? *
In no more than 1-2 pages, please introduce yourself and your documentary experiences. Let us know why you wish to join the Diverse Voices in Docs Program, and what you hope to gain from the experience. *
You might want to write this in a word doc, and copy and paste in here when ready!
What documentary project will you pursue through Diverse Voices in Docs? *
You might want to write this in a word doc, and copy and paste in here when ready!
If selected as a fellow for the program, I hereby consent to the use of my photographs, film, or copies thereof in any editorial, program development, and/or promotional material produced and/or published by Kartemquin Films. *
Demographic Information (OPTIONAL)
Kartemquin does not discriminate on the basis of age, gender identity or expression, sexual orientation, or disability. In order to track the reach of our recruiting efforts, please consider answering the following optional questions.
Age
What is your gender?
What are you pronouns ?
Do you consider yourself a member of the Lesbian, Gay, Bisexual and/or Transgender (LGBT) community?
Do you have a disability?
If you have a disability, will you require a reasonable accommodation to participate in this fellowship? (Examples of reasonable accommodation might include wheelchair accessible workshop locations, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.)
Submit
Never submit passwords through Google Forms.
This form was created inside of Kartemquin Films. - Terms of Service - Additional Terms