Application Form2023 LATC GLOBAL FILM & TV PROGRAMApplication Deadline: October 18thStep 1 of 333%Tell us who you areYour professional information will be included in the Digital Program Handbook.1.1) Full Name*Passport Given Name(s)Passport Surname This field must be filled with your full name in the same way as written on your passport.Preferred/badge Name*Write here your preferred/artistic/professional name. How do you want to be called for us?Which name do you prefer to use for your certificate of participation? Passport Full Name Preferred Name 1.2) Date of Birth* DD slash MM slash YYYY 1.3) Nationality*1.4) Contact Info*PhoneWhatsapp E-mail* Enter Email Confirm Email 1.5) Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country 1.6) Professional DataOccupationPosition/ Job Title CompanyWebsite 1.8) Short professional biography*Write a short text of up to 500 characters in English.Headshot*Upload your photo to be included in the Program Book. (Accepted file types: jpg, png or pdf) File size: up to 2MB.Accepted file types: jpg, png, pdf, Max. file size: 5 MB.1.8) What is your main objective with the LATC Program?* Learn about the U.S. and Global industry Develop or improve my pitch techniques and skills Connect with international industry executives and professionals Networking with LA-based industry leaders and experts 1.9) Do you have a project, concept or completed work that you wish to share with other participants and speakers?*If so, complete the next section. If your answer is No, jump to the final application form section. To receive feedback on your project, you must complete the next section. Yes NoTell us about your project, concept or completed workThis section information will be included in the Program Handbook. Also, if you want to receive feedback on your project, please complete this section.2.1) What kind of work would you like to present? Audiovisual Project Concept Script Treatment Completed work2.2) What stage is your work at? Script stage Project in Development Pre-production Post-production Completed2.3) Screenplay Original Based on an existing work Based on in the life of a personality 2.4) Title In English Original Title 2.5) LanguageOriginal LanguageOther Language 2.6) Country | Co-productionOriginal CountryCo-production | Other Country(ies) Is it going to be an international co-production? If so, which countries are involved? Mention it in the field Other Country(ies), "Co-production with..."2.7) BudgetTotal Budget in USDUS$ funded to date 2.8) Format Feature film Series Transmedia Documentary Web 2.9) Genre Action Comedy Horror Thriller Family Romance 2.10) Running Time2.11) Logline2.12) StorylineUp to 700 characters in English2.13) Screenwriter Information (if appropriate)Full name, brief bio, comments. Up to 700 characters in English.2.14) Director Information (if appropriate)Full name, brief bio, comments. Up to 700 characters in English.2.15) Production Information (if appropriate)The production company, producer, brief bio, city, country, and website. Up to 1000 characters in English.2.16) Notes from the producer on development strategiesIt could include a synopsis, a tentative cast, a distribution agreement, and other information. Up to 1000 characters in English.2.17) Attachment: Art Work/Poster/ImageUpload an image of your work.Accepted file types: jpg, png, jpeg, Max. file size: 10 MB.2.18) Attachment: Financing PlanUpload an image of your work.Accepted file types: jpg, png, jpeg, Max. file size: 10 MB.2.19) How and where do you intend to raise funds for your projects?Up to 500 characters in English.2.20) Are there underaged actors/actresses in the Project? Yes No2.21) Are there underaged actors/actresses in the Project? Yes No2.22) Are the project/work rights cleared?You can mention which agreements or contracts you already have or not.The LATC Pitch PanelThe Pitch Panel is an opportunity to pitch your work to a select group of independent producers and industry professionals, with immediate feedback and tips. This is an optional and exclusive experience for participants of the LATC 2023 GLOBAL FILM & TV PROGRAM. To access this experience, you must submit a 2-4 minute video pitch by September 28th.2.21) Do you want to pitch your work live to the Pitch Panel?* Yes. No, I don't.2.22) 2-4 minute Video pitchThe 2-4 minute video pitch is required for those who want to present your project/work in the Pitch Panel. It's a presentation in English of your project, concept, or completed work including the participant's name, the genre, and the subject/theme of your work. The video file is 10MB maximum.Accepted file types: mp4, mov, avi, Max. file size: 10 MB.Select your pass and accept terms & conditionsConfirm your pass and payment options, and accept program terms & conditions.3.1) Indicate your Program Pass Option*The 10% Early bird discount is available up to August, 7th. Full Program-Pass WITH accommodation & transportation: USD 3500 | Early bird: USD 3150 Full Program-Pass WITHOUT accommodation & transportation: USD 2000 | Early bird: USD 1800 Scholarship Participant3.2) Payment Method Paypal System Bank Transfer to LATC account in the U.S. Bank Transfer to LATC account in Brazil None. I've received a scholarship.Upon submission of this form, if necessary, you will receive an email with the Invoice and Payment Instructions.3.3) Please read carefully and accept ALL the LATC Program Terms & Conditions:* I confirm that the information providen in this form is true, complete and accurate. I declare I retain the copyright and other relevant rights of all material included in this form, and I am duly authorized to present it in the LATC GLOBAL FILM & TV PROGRAM and have full rights to present it to potential partners. I agree to hold LATC, its officers and its staff harmless and exempt from any liability, claims or losses in connection with the project, or concept or complete title I present during the LATC Program. I agree to participate in ALL program activities. In the event I fail to attend, the corresponding fee paid will be forfeited. I understand and agree that LATC shall be permitted to utilize my images and professional information for promotion of LATC current and future programs activities. I understand that the LATC Program will be conducted in English in-person in Los Angeles and the Program does NOT include air tickets or travel costs. I understand that eventual alterations in the program schedule and speakers may be made without prior notice at the discretion of LATC staff due to their availability. 63664Δ