EFTA02673139

NEW YORE FILM ACADEMY SHORT-TERM WORKSHOPS [email protected] 212-674-4300 APPLICATION www.nyfa.edu GENERAL INFORMATION NON-REFUNDABLE APPLICATION FEE $50 USD K CHECK ENCLOSED K WIRE TRANSFER K MONEY ORDER K CREDIT CARD K CASH COUNTRY OF CITIZENSHIP (MUST BE COMPLETED) K UNITED STATES K OTHER (SPECIFY) • Have you served in the United States Mditary? K YES K NO Are you a former student of New York Film Academy? K YES K NO FAMILY NAME FIRST NAME ADDRESS CITY STATE ZIP COUNTRY PRIMARY TELEPHONE SECONDARY TELEPHONE FAX EMAIL MALE/FEMALE AGE CITIZENSHIP BIRTH DATE(Month (Day (Year) SOCIAL SECURITY NUMBER (AN VS applicants must plod* PARENT/GUARDIAN RELATIONSHIP TELEPHONE EMAIL SECONDARY EMERGENCY CONTACT RELATIONSHIP TELEPHONE EMAIL SCHOOL ATTENDED MAJOR COMPANY POSITION FOR AFA. BFA, MFA, MA, I8.2-YEAR CONSERVATORY, AND ONLINE WORKSHOPS APPLICANTS: PLEASE FILL OUT SEPARATE APPLICATION FILMMAKING K 8-Week Film 8 Hi-Def • K Rolling Stone 8-Week Music Video K 6-Week Film & Hi-Def K 4-Week Filmmaking K 4-Week Hi-Def Filmmaking K Rolling Stone 4-Week Music Video K 3-Week Filmmaking K 3-Week Hi-Def Filmmaking K 1-Week Hi-Def Filmmaking K 1-Week Music Video K Special Holiday Filmmaking Workshop PHOTOGRAPHY K 8-Week Photography K 4-Week Photography PRODUCING K 4-Week Producing ACTING FOR FILM K 8-Week Acting for Film K 4-Week Acting for Film K 3-Week Acting for Film K 1-Week Acting for Film K Special Holiday Acting Workshop BROADCAST JOURNALISM K 8-Week Broadcast Journalism K 4-Week Broadcast Journalism MUSICAL THEATRE K 4-Week Musical Theatre DIGITAL EDITING K 4-Week Digital Editing K Professional Editing with Avid Media Composer 'Students Applying to Florence, Australia, Abu Ohabi Campus will shoot with Ni-Del Only 3D ANIMATION K 4-Week 3D Animation K 3-Week 3D Animation SCREEN WRITING K 8-Week Screenwriting EVENING PROGRAMS & WORKSHOPS K 12-Week Evening Filmmaking K 12-Week Evening Hi-Def Filmmaking K 12-Week Evening Acting for Film K 12-Week Evening Comedy Program K 12-Week Evening Broadcast Journalism K 12-Week Evening Producing K 12-Week Evening Screenwriting K 12-Week Evening Photography K 12-Week Evening Digital Editing IMPORTANT: PLEASE INDICATE START DATE AND LOCATION START DATE (Month May /Year): ■ HOUSING NEEDED K New York City K Los Angeles. CA K Abu Dhabi, UAE K South Beach. Florida K Harvard University K Disney Studios, Florida K Queensland. Australia K Sydney, Australia K Florence, Italy K Paris. France K Rio De Janeiro, Brazil K Mumbai. India K Beijing, China K Shanghai. China K Kyoto, Japan K Jakarta, Indonesia HOW DID YOU LEARN ABOUT THE NEW YORK FILM ACADEMY? Web 0 Google K rollingstone.com K vimeo.com K Search for School K Yahoo K Ask K msn K bing K Other Social Media K Facebook K Twitter K Google+ K Blog K Other Ad K Telephone Booth K Subway K Bus K Mall K Magazine K TV Spot K NYFA Café K 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_0 1048527 EFTA02673139 NEW YORE SHORT-TERM WORKSHOPS FILM ACADEMY APPLICATION [email protected] 212-674-4300 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? K No K 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? K No K 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) K No. not Hispanic or Latino HOW WOULD YOU DESCRIBE YOURSELF? K American Indian or Alaska Native K Asian K Black or African American K Native Hawaiian or Other Pacific Islander K White K 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 Please return completed copy to the Director of Admissions or apply online at www.nyfa.edu. DATE (Month /Day Near) NEW YORK FILM ACADEMY OFFICE OF ADMISSIONS 1100 EAST 17TH STREET NEW YORK. NY 10003 'TEL: 212-67443001 FAX: 212-477-1414 EFTA_R1_01948528 EFTA02673140