Travel Assistance: Established Production Company (EPC) Application Form

Before completing this form please read the relevant Guidelines in conjunction with the Screenwest Terms of Trade.

1.0 Application summary
Application Date
Fund Applying For / Travel Assistance: Established Production Company (EPC)
Funding Request / $
Start Date / 1 October 2017
Completion Date / 30 September 2018
2.0 Applicant details
Applicant / Applicant Company
ABN
Year Incorporated
Registered Business Address
State / Post Code
Applicant Contact Name
Address (if different)
State / Post Code
Mobile / Work
Email
Website
3.0 Statistical information for this application
Is the applicant aged between / 18-24 25-34 35-44 45-54 55-64 65+
Is the applicant male or female? / Male Female
Is the applicant company based in Western Australia? / Yes No
Is the applicant a Western Australian Resident as defined in the Terms of Trade? / Yes No
Does the applicant identify as Indigenous? / Yes No
Will there be any Indigenous content involved in this application’s activities/project(s)? / Yes No
Will there be any Indigenous people involved in this project? you complete / Yes No
4.0 Applicant’s current funding obligations
Activity/project currently in receipt of funding (not yet acquitted) / Current status/ action required / Delivery date
5.0 Marketing and financing strategy
Describe the planned trade and, if applicable, consumer marketing and financing strategy for the project slate relevant to the proposed travel (maximum 500 words). (Box expands as you type.)

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6.0 Current slate to be pitched in the travel envisaged below
Minimum of three projects must be identified.
Project Format / Logline / Genre / Current Stage of Development (eg. Treatment Stage, 3rd Draft Script, etc.) / Key Creatives Attached / Market Interest or Intended Market
[Insert Slate Project Title]
[Insert Slate Project Title]
[Insert Slate Project Title]
[Insert Slate Project Title]
[Insert Slate Project Title]
7.0 Proposed travel for 1 October 2017– 30 September 2018

Screenwest contribution per trip is capped. Use the following Cap Category table to complete the estimated budget and your request.

CAP CATEGORY / Type of trip / Cap amount
IT / International Travel / Up to $6,250
ITAP / International Travel (Asia Pacific) / Up to $3,000
IT MULTI / International Travel Multi-countries (two (2) or more not including stopovers) / Up to $8,000
NAT / National Travel / Up to $1,500
Destination, purpose and indicative dates (where details are not yet determined describe what is likely and “tbc”) / List Business Objectives
(Must be specific and measurable) / Cap Category
(IT, ITAP, IT MULTI, NAT) / SW contribution request / Estimated economy flights costs / Estimated. Accommodation costs / Estimated registration fee (if applicable) / Estimated additional cost of trip to be incurred by Applicant / Trip
Total
[Example: Sydney business meetings with ABC & Nine - 1/10/2017 to 4/10/2017] / Secure commission of at least one slate project / NAT / $1,300 / $700 / $600 / NA / $240 / $1,540
[Example: Perth – London - Canada - 15/1/2018 to 30/1/2018] / Secure commission of at least one slate project / IT MULTI / $7,000 / $4,000 / $3,000 / NA / $2,000 / $9,000
TOTALS / SW total contribution requested:
$ / Total Applicant Contribution:
$ / Trip Total Costs:
$

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8.0 Application checklist
Below are the required materials that should be submitted together in one email with PDFs that are clearly labeled. / Check once attached
(double click on box)
1. / A completed Travel Assistance: Established Production Companies (EPC) Application Form
2. / Evidence in the form of final cost or audit reports of a minimum of $1.5Million in QWAE from eligible productions incurred in the last two financial years.
9.0 Applicant warranty
In submitting this application, I, the applicant warrant that:
·  I have read, understand and adhere to Screenwest's current relevant guidelines and Terms of Trade. In particular, I acknowledge that Screenwest reserves the right to vary any of its terms and conditions without notice.
·  I have or will have fully acquitted previous Travel Assistance grants (including 2016-17 EPC) on or before 30 October, 2017 and have contacted the program contact to advise when acquittal will be provided to Screenwest.
·  I acknowledge that no part of a new EPC travel grant will be cashflowed until the previous EPC travel grant has been fully acquitted and the acquittal approved by Screenwest.
·  I am not a full-time student at a secondary school or a full-time student at a tertiary institution (including at a film school).
·  I will always act in good faith in all dealings with Screenwest.
·  I have the capacity, resources and rights to carry out the proposal listed above.
Signed / [Electronic name / signature is acceptable]
Name / Title / Date

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