EFTA02673099.pdf

NEW YORE SHORT-TERM WORKSHOPS [email protected] 212-674-4300 FILM ACADEMY APPLICATION www.nyfa.edu GENERAL INFORMATION NON-REFUNDABLE APPLICATION FEE FAMILY NAME FIRST NAME $50 USD ❑ CHECK ENCLOSED COUNTRY ❑ WIRE TRANSFER ADDRESS CITY STATE ZIP ❑ MONEY ORDER ❑ CREDIT CARD PRIMARY TELEPHONE SECONDARY TELEPHONE FAX ❑ CASH COUNTRY OF CITIZENSHIP EMAIL MALE/FEMALE AGE (MUST BE COMPLETED) ❑ UNITED STATES CITIZENSHIP BIRTH DATE(Month (Day (Year) SOCIAL SECURITY NUMBER (AN VS applicants must plod* ❑ OTHER (SPECIFY) • PARENT/GUARDIAN RELATIONSHIP TELEPHONE EMAIL Have you served in the SECONDARY EMERGENCY CONTACT RELATIONSHIP TELEPHONE EMAIL United States Mditary? ❑ YES ❑ NO SCHOOL ATTENDED MAJOR Are you a former student of New York Film Academy? POSITION ❑ YES ❑ NO COMPANY FOR AFA. BFA, MFA, MA, I8.2-YEAR CONSERVATORY, AND ONLINE WORKSHOPS APPLICANTS: PLEASE FILL OUT SEPARATE APPLICATION FILMMAKING ACTING FOR FILM 3D ANIMATION ❑ 8-Week Film 8 Hi-Def • ❑ 8-Week Acting for Film ❑ 4-Week 3D Animation ❑ Rolling Stone 8-Week Music Video ❑ 4-Week Acting for Film ❑ 3-Week 3D Animation ❑ 6-Week Film & Hi-Def ❑ 3-Week Acting for Film ❑ 4-Week Filmmaking ❑ 1-Week Acting for Film SCREENWRITING ❑ 4-Week Hi-Def Filmmaking ❑ Special Holiday Acting Workshop ❑ Rolling Stone 4-Week Music Video ❑ 8-Week Screenwriting ❑ 3-Week Filmmaking BROADCAST JOURNALISM ❑ 3-Week Hi-Def Filmmaking ❑ 8-Week Broadcast Journalism EVENING PROGRAMS & WORKSHOPS ❑ 1-Week Hi-Def Filmmaking ❑ 4-Week Broadcast Journalism ❑ 12-Week Evening Filmmaking ❑ 1-Week Music Video ❑ 12-Week Evening Hi-Def Filmmaking ❑ Special Holiday Filmmaking Workshop MUSICAL THEATRE ❑ 12-Week Evening Acting for Film ❑ 4-Week Musical Theatre ❑ 12-Week Evening Comedy Program PHOTOGRAPHY DIGITAL EDITING ❑ 12-Week Evening Broadcast Journalism ❑ 8-Week Photography ❑ 12-Week Evening Producing ❑ 4-Week Photography ❑ 4 -Week Digital Editing ❑ Professional Editing with ❑ 12-Week Evening Screenwriting PRODUCING Avid Media Composer ❑ 12-Week Evening Photography ❑ 4 -Week Producing ❑ 12-Week Evening Digital Editing 'Students Applying to Florence, Australia, Abu Ohabi Campus will shoot with Ni-Del Only IMPORTANT: PLEASE INDICATE START DATE AND LOCATION START DATE (Month May /Year): ❑ New York City ❑ Harvard University ❑ Florence, Italy ❑ Beijing, China ❑ Los Angeles. CA ❑ Disney Studios, Florida ❑ Paris. France ❑ Shanghai. China ❑ Abu Dhabi, UAE ❑ Queensland. Australia ❑ Rio De Janeiro, Brazil ❑ Kyoto, Japan ■ HOUSING NEEDED ❑ South Beach. Florida ❑ Sydney, Australia ❑ Mumbai. India ❑ Jakarta, Indonesia HOW DID YOU LEARN ABOUT THE NEW YORK FILM ACADEMY? Web 0 Google ❑ rollingstone.com ❑ vimeo.com ❑ Search for School ❑ Yahoo ❑ Ask ❑ msn ❑ bing ❑ Other Social Media ❑ Facebook ❑ Twitter ❑ Google+ ❑ Blog ❑ Other Ad ❑ Telephone Booth ❑ Subway ❑ Bus ❑ Mall ❑ Magazine ❑ TV Spot ❑ NYFA Café ❑ Other Friend VITA Student Teacher. Agent, or Counselor I Fair College Brochure U Other NEW YORK FILM ACADEMY OFFICE OF ADMISSIONS 1100 EAST 17TH STREET NEW YORK. NY 100031 TEL: 212.674-43001 FAX: 212-477-1414 EFTA_R1_01048451 EFTA02673099  NEW YORE SHORT-TERM WORKSHOPS [email protected] 212-674-4300 FILM ACADEMY APPLICATION www.nyfa.edu PLEASE TELL US WHY YOU WOULD LIKE TO ATTEND THE NEW YORK FILM ACADEMY: ANYTHING ELSE YOU WOULD LIKE TO TELL US? IS THERE ANY HEALTH PROBLEM THAT NYFA SHOULD KNOW ABOUT? ❑ No ❑ Yes navvy vas physic'an contact in) HEALTH INSURANCE COMPANY GROUP/POLICY # We strongly advise students to acquire health insurance coverage, please contact us for more information. HAVE YOU EVER BEEN CONVICTED OF A MISDEMEANOR, FELONY, OR OTHER CRIME? ❑ No ❑ Yes If yes. please attach a separate sheet of paper that gives the approximate date(s) of the incident(s) and explains the circumstances. ARE YOU HISPANIC/LATINO? ❑Yes,Hispanic or Latino (including Spain) ❑ No. not Hispanic or Latino HOW WOULD YOU DESCRIBE YOURSELF? ❑ American Indian or Alaska Native ❑ Asian ❑ Black or African American ❑ Native Hawaiian or Other Pacific Islander ❑ White ❑ Other To process your application, please submit a non-refundable fee of S50. Please make your check or money order, in US dollars, payable to: THE NEW YORK FILM ACADEMY, LTD. In order to make a payment by credit card or wire transfer, please contact us. Details regarding payment schedule will be sent with acceptance notification. For a copy of the NYFA rules and regulations. and the refund policy, please contact the admissions office. All dates, locations, schedule, curriculum, and tuition are subject to change. The New York Film Academy reserves the right to use a student's name, likeness or films in brochures, advertising, the web, and in any other promotional materials or for educational purpose. Our workshops are extremely intensive and comparable to an Outward Bound and Boot Camp experience in film production. Students may request that their studies and course work be considered for a transfer or award of credit by the New York Film Academy's west coast headquarters at Los Angeles. California. To qualify, students must meet all admissions criteria, standards of course work. attendance. and the course of study must have been deemed equivalent to an approved course at the New York Film Academy at Los Angeles, California. The New York Film Academy reserves the right to dismiss students from programs for poor conduct, poor attendance, lack of preparation, if they present a threat to themselves or others, or if they cause a disruption of any kind. STUDENT'S SIGNATURE DATE (Month /Day Near) Please return completed copy to the Director of Admissions or apply online at www.nyfa.edu. NEW YORK FILM ACADEMY OFFICE OF ADMISSIONS 1100 EAST 17TH STREET NEW YORK. NY 10003 'TEL: 212-67443001 FAX: 212-477-1414 EFTA_R1_01948452 EFTA02673100