PARTICIPANT APPLICATION — SOMERSET FILM AND VIDEO

BFI Film Academy delivered by:
BFI Film Academy 19/20 Participant Application Form

UK Network Programme
Please check the following statements to confirm your eligibility for the programme:
Section 1: Applicant Information

Your contact details
Name *

First Name Last Name
Email: *
Date of birth *

Day Month Year
Date Picker Icon

Address *

Street Address
Street Address Line 2
City	County
Post code	Country

Current School/college
Do you, or have you, received Free School Meals in the last three years? *

YES NO Prefer not to say
Full dates of the course are: Saturday 19th and 26th Oct and Half-term 28th Oct to 1st Nov 2019
Can you attend all course dates between 19 OCT 2019 — 01 NOV 2019 *

YES NO
If no, please specify which days you are unable to attend:
SECTION 2: Supporting statements
- Please note it is likely there will be more applications than places and applicants will be selected based on their responses and material submitted through this application form.
- Please use this section to tell us why you’re the right person to be accepted on this course.
- We strongly encourage you to save your supporting statements in a word processor and cut and paste them into the application form to avoid any loss of work, should you lose your internet connection
Why do you want to take part in the BFI Film Academy? Please tell us about yourself and what difference you hope the Film Academy will make to you? *

0/250
Please tell us about your experience and/or interest in film. You can submit some work such as a film, photograph, piece of writing, link to a website or an animation e.t.c. to support your answer. *

0/250
Please use this space to tell us if you have any particular areas of interest in film or film-making such as directing, programming, script-writing, visual effects, sound design, e.t.c. *
How did you learn about the BFI Film Academy? This will help us tell people about the programme more effectively next year. *

School/teacher Family/friend Website Twitter The BFI
Section 3: Terms and Conditions
The BFI Film Academy will be provided by BFI Academy Partner named in this application. Your submission of this form to us will constitute your confirmation of the following declaration:
- I hereby confirm that the information I have given in this application is true and correct
- I confirm my availability for the BFI Film Academy as per the dat es given above
- I agree that the BFI Academy Partner and /or the BFI may, for administrative purposes only, make copies of any material submitted in support of my application.
- By submitting this form, I understand that BFI Future Film and the BFI will store and process my data as described below in accordance with professional standards and data protection legislation.
- If under 18 I confirm that my parent or guardian has given me permission to apply to the BFI Film Academy
Data Protection
- In order for you to be able to parti cipate in the BFI Academy Partner needs to be able to process your personal data as part of the applications, registration, learning support, and awards processes.
- Part or all of the information you g ive BFI Academy Partner will be provided to the BFI.
- The BFI will retain this information following your participation in the Film Academy for statistical purposes only, unless otherwise agreed.
- The BFI may share your name and contact details with a company who helps evaluate the BFI Film Academy. They may contact you to invite you to participate in a survey evaluating the course.
The BFI and BFI Academy Partner would like to stay in touch and email you with news and information on events, courses and training opportunities which the BFI and BFI Academy Partner thinks you may be interested in (for example, nearby events or courses in your area of interest).
If you would like to receive these updates please tick YES here: *

YES NO
Your Signature *

Use your mouse or trackpad to type your signature here Clear
Diversity and Inclusion Monitoring Form
The British Film Institute wish to ensure that all aspects of our work reflect diversity and support equality of opportunity. Therefore, we would like to take this opportunity to ask you to complete an equality monitoring form.

This monitoring information helps us to identify where there are gaps in our recruitment so that we can work to attract talented people from these groups and areas. It also helps us to ensure that there is no discrimination.

Your cooperation in completing this form is greatly appreciated.

Any information you provide us with will be processed separately to your application to the BFI Film Academy and used for equalities monitoring purposes only. We use this information to produce anonymised statistical data on equalities, which we may publish and share with the government departments providing our funding.

Please note you will need to return this form as part of your application, providing any of the information requested is optional.
Gender *

Female Male Prefer not to say
Is the gender indicated the same as your gender at birth? *

Yes No Prefer not to say
Ethnic Origin — Please tell us about your ethnic origin (or tick our closest UK Census based category) *

Asian/Asian British — Indian Asian/Asian British — Pakistani Asian/Asian British — Bangladeshi Asian/Asian British — Chinese Any other Asian background Black/African/Caribbean/Black British — Caribbean Black/African/Caribbean/Black British — African Any other Black/African/Caribbean background Mixed/multiple ethnic groups — White and Black Caribbean Mixed/multiple ethnic groups — White and Black African Mixed/multiple ethnic groups — White and Asian Any other mixed/multiple ethnic groups background White — British (English/Welsh/Scottish/Nothern Irish) White — Irish White — Gypsy or Irish Traveller Any other White background Other ethnic group — Arab Other ethnic group — Any other background Prefer not to say
Socioeconomic background: Have you ever been in care? That is, looked after by the state. *

Yes, I’m currently in care Yes, in the past No, I’ve never been in care Prefer not to say
Do you consider yourself to have a disability? (Disability: The Equality Act 2010 defines disability as 'a physical or mental impairment which has a substantial long term effect on a person’s ability to carry out normal day to day activities'.) *

Yes No Prefer not to say
If yes, please give details:
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BFI Film Academy 19/20 Participant Application Form

Section 1: Applicant Information

SECTION 2: Supporting statements

Section 3: Terms and Conditions

Diversity and Inclusion Monitoring Form