Digital Cinema Camera Skills: application form

Please answer all questions as fully as possible

First Name……………………………….Surname…….……………….…………………………

.

Address…………………………………………………………………………….……………………..

Postcode…………………………………Borough/County ………………………..……………

Telephone…..…………………………………Mobile……………………………………………………

Email…………………………………………………………………………………………………….…………

Age …………………Date of birth ………………… Male……………Female……………

1. Your work

Are you a freelancer/company working in the creative media industry? Yes / No

What is your department/specialism?

How many years have you been working in the industry? ……………………………..

Are you currently employed? Yes / No

If ‘No’ how many months have you been unemployed? ………………………………………..

Roughly how many months have you worked during the last year? …………………..

Have you attended any training courses during the past 2 years? Yes / No

If yes, where was the training, and what did it cover?

2. Why are you applying for this training course? What do you hope to gain from it?

3. Do you have any specific access needs? If yes, please provide details.

4. Hardship. We aim to make this course accessible for all. If you believe you have a case of real hardship, please attach a letter providing details and evidence. This can include childcare, travel, disability support or accommodation costs. We will consider all reasonable requests.

5. Have you attended a Four Corners course before?Yes/No

If yes, which course and when?

6. Where did you hear about this scheme/Four Corners?

7. Please sign and date this application

I declare that the details given on this application form are true to the best of my knowledge.

Signature:Date:

Please return to Four Corners with a copy of your current CV, and complete the statistical information on the next page.

Four Corners

121 Roman Road

London E2 OQN

T. 020 8981 6111

This programme is supported by Creative Skillset’s Film Skills Fund, which is funded by the BFI with National Lottery funds, through the Skills Investment Fund


Statistical information: please complete

Please complete the following information for our funding requirements. The information you provide will be used to provide statistical data only.

Please circle the answers that apply to you.

Do you have a disabilityYesNoPrefer not to say

Do you have a long-term health issue (12 months plus) that affects your daily activities?

Which of the following groups do you belong to?

1. White - British2. White – Irish

3. White – Other4. Mixed White and Caribbean

5. Mixed – White and African6. Mixed White and Asian

7. Mixed – Other8. Asian or Asian British – Indian

9. Asian or Asian British – Pakistani10. Asian or Asian British – Bangladeshi

11. Asian or Asian British – other12. Black or Black British – Caribbean

13. Black or Black British – African14. Black or Black British - other

15. Chinese16. Other

17. Prefer not to say

What is the highest qualification you hold?

GCSEA levelNVQ (note level) Undergraduate

Post graduateNo qualificationsOther (please specify)

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121 Roman Road, Bethnal Green, London E2 OQN T. 020 8981 6111 F. 020 8983 7866

E. .