Application for Listing
Print
out this form, fill it in and mail it with a check to
Pax Media Inc.
P.O. Box 754, Sooke, BC, V0S 1N0
| One year Listing: (includes GST) ____ Individual $20.00 ____ Non Profit Group or club $35.00 ____ Business $50.00 |
Listing benefits: Listing on "Film in BC, Canada" Database Hot link to your existing page or Web page creation for minimal extra charge Invitations to Vancouver Island media events (Filmfest awards night) and screenings |
Name: (real)________________________________________
Stage Name or Group:________________________________
Address: __________________________ City______________
Prov ___________________ Postal Code ________ ___________
Phone: ______________________ Fax______________________
E
mail: _________________________________
What
is your area of expertise?____________________________
______________________________________________________
Do you have photos or logos available? If so, please enclose
Would
you like a listing in the database? _____ yes or no________
Use the back of
this page to give up to 20 word description for Database listing
The
category I want to be listed on the "Film in BC, Canada" database is:(Circle
your listing:)
Performer:
1a. Actor/Extra, 1b. Musician/Singer, 1c. Mime, 1d. Voice, 1e. Model, 1f. Other:
Describe:
__________________________________________________________________________
2. Locations:
2a. Building: Describe: ____________________________________________
(examples:
cafe, hotel, B&B, plane hangar, mill, industrial plant, office, unique or
ordinary home)
2b. Outdoor site: Describe:
___________________________________________________
(examples: wharf,
meadow, bridge, barn, country lanes, monuments, gravel pit, caves)
3.Agents:
3a. Registered talent / model agent, 3b. Musical representative, 3c. Animal
Trainer, 3d. Other: Describe:
______________________________________________________________________
4.
Training:
4a. Acting School, 4b. Computer School, 4c. Film School,
4d. Other: Describe:
______________________________________________________________________
5. Props: (Vehicles: boats, cars, trucks, other)
Props: (housewares, tools, weapons) Props:Set Design faux painting, polyresin,
fiberglass
6. Costume Cutter / Designer, 7. Makeup / (body)special effects,
prosthesis
8. Special Effects (including pyrotech & lighting: stage &
outdoor)
9. Production- Describe: _______________________________________________
10. Writer, 11. Craft Services
12. Services: Carpentry / Electrician
/ Security/ Transportation
Any other not listed:___________________________________________________
I want a "hot link" to my existing web page: the address is:
http://_________________________________
I do not have a web page, but would like one created __________
Note:
application does not guarantee acceptance.
Questions? Email: listme@film.bc.ca
or phone 250 642-6745