NEW VCRIC 1 & 2 YEAR CONSERVATORY PROGRAMS FILM ACADEMY APPLICATION [email protected] 212-674-4300 www.nyfa.edu GENERAL INFORMATION FAMILY NAME FIRST NAME ADDRESS CITY STATE ZIP COUNTRY PRIMARY TELEPHONE SECONDARY TELEPHONE FAX EMAIL MALFJFEMALE AGE CITIZENSHIP BIRTH DATE(Month /Day New) SOCIAL SECURITY NUMBER (AR US eywcants mau provide) PARENT/GUARDIAN RELATIONSHIP TELEPHONE EMAIL SECONDARY EMERGENCY CONTACT RELATIONSHIP TELEPHONE EMAIL SCHOOL ATTENDED MAJOR COMPANY POSITION NON-REFUNDABLE APPLICATION FEE $75 USD ❑ CHECK ENCLOSED ❑ WIRE TRANSFER ❑ MONEY ORDER ❑ CREDIT CARD ❑ CASH COUNTRY OF CITIZENSHIP (MUST 8E COMPLETED) ❑ UNFTED STATES ❑ OTHER (SPECIFY) • Have you served in the United Stales Military? ❑ YES ❑ NO Na you a former student of New York Film Academy? ❑ YES ❑ NO FOR AFA, BFA, MFA, MA, SHORT-TERM WORKSHOPS, AND ONLINE WORKSHOPS APPLICANTS: PLEASE FILL OUT SEPARATE APPLICATION FILMMAKING ❑ Two-Year Conservatory Filmmaking ❑ One-Year Conservatory Filmmaking ❑ Semester Filmmaking (Florence Onfy) ACTING FOR FILM 0 Two-Year Conservatory Acting for Film One-Year Conservatory Acting for Film O Semester Acting for Film (Florence Only) PRODUCING ❑ One-Year Conservatory Producing SCREENWRITING ❑ One-Year Conservatory Scseenwriting DOCUMENTARY FILMMAKING ❑ One-Year Conservatory Documentary Filmmaking BROADCAST JOURNALISM ❑ One-Year Conservatory Broadcast Journalism MUSICAL THEATRE ❑ Two-Year Conservatory Musical Theatre & Film ❑ One-Year Conservatory Musical Theatre PHOTOGRAPHY O Two-Year Conservatory Photography o One-Year Conservatory Photography CINEMATOGRAPHY ❑ One-Year Conservatory Cinematography 3D ANIMATION ❑ One-Year Conservatory 3D Animation GAME DESIGN ❑ One-Year Conservatory Game Design IMPORTANT: PLEASE INDICATE START DATE AND LOCATION START DATE (Month /Day Near): ■ HOUSING NEEDED ❑ New York City ❑ Los Angeles, CA ❑ South Beach, FL ❑ Queensland, Australia ❑ Sydney, Australia ❑ Florence. Italy ❑ Abu Dhabi. UAE HOW DID YOU LEARN ABOUT THE NEW YORK FILM ACADEMY? Web L Google ❑ rollingstone.com ❑ vimeo.com ❑ Search for School ❑ Yahoo ❑ Ask ❑ msn Social Media ❑ Facebook ❑ Twitter ❑ Google. ❑ Blog ❑ Other Ad ❑ Telephone Booth ❑ Subway ❑ Bus ❑ Mall ❑ Magazine ❑ TV Spot ❑ NYFA Cafe ❑ Other ❑ Friend ❑ NYFA Student ❑ Teacher. Agent, or Counselor ❑ Fair ❑ College ❑ Brochure ❑ Other ❑ hing ❑ Other NEW YORK FILM ACADEMY OFFICE OF ADMISSIONS 1100 EAST 17TH STREET NEW YORK. NY 10003 1 TEL: 212-674-4300 I FAX: 212-477-1414 EFTA_R1_01948525 EFTA02673137 MEW von 1 & 2 YEAR CONSERVATORY PROGRAMS :11^2,:rast 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? D No OYeS(Haveyourphympancontaclus) HEALTH INSURANCE COMPANY GROUP/POLICY it 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? O No O Yes If yes. please attach a separate sheet of paper that gives the approximate date(s) of the incidenl(s) and explains the circumstances. ARE YOU HISPANIC/LATINO? OYes. Hispanic or Latino (including Spain) O No. not Hispanic or Latino HOW WOULD YOU DESCRIBE YOURSELF? O American Indian or Alaska Native O Asian O Black or African American O Native Hawaiian or Other Pacific Islander O White O Other To process your application, please submit a non-refundable fee of $75. 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 NEW YORK FILM ACADEMY OFFICE OF ADMISSIONS 1100 EAST 17TH STREET NEW YORK, NY 10003 I TEL: 212-674-4300 I FAX: 212-477-1414 EFTA_R1_01948526 EFTA02673138