Discretionary Fund Application Thanks for taking the time to read the Discretionary Fund guidelines (download *PDF) before completing this form. The guidelines include instruction for submitting other elements of your application, incomplete applications will not be reviewed.
Program Title *
Summary Description of Project *
Project Budget *
Amount of Request *
Funding Category (Check one) * R&D
Production
Post-Production
Program Length * Short
26:40
56:40
86:40
Other Program Length
Program Format * HD
Standard Video
Small Format
Film
Program Type * Fiction
Non-Fiction
Positions Held by Person of African Descent (Check all that apply) Producer
Director
Writer
Cinematographer
Editor
Program Website (if any):
ABOUT THE PRODUCER
Name
Prefix
First
Last
Suffix
Company
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Email
Phone Number
Fax Number
ABOUT THE DIRECTOR
Name
Prefix
First
Last
Suffix
Company
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Email
Phone Number
Fax Number
FISCAL SPONSOR
Company
Contact Name
Prefix
First
Last
Suffix
Title
Email
Phone Number
Fax Number
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Upload a .zip file containing, PDFs, or Microsoft Word Documents for your other application elements. ALL DVD/VIDEO WORK SAMPLES MUST BE SENT BY MAIL TO: NBPC, ATTN: AfroPoP. 68 East 131st Street, 7th Floor, New York, NY 10037
I have the right to submit this program and I agree to the statement below. I certify that the information contained in this application, including all attachments and supporting materials is true and correct to the best of my knowledge. I Agree
I Disagree
Image Verification