A FATHER'S DIARY

FILM AUDITION FORM

Thank you for your interest in our 20 minutes independent short film “A FATHER'S DIARY.” Please fill out the following information
and email to BanzaiMultimedia@gmail.com as early as possible to schedule your audition. You will be required to sign this form
during the audition for video / film recording purpose. If you have any other information to share, please fill out on a separate sheet
or on the back of the form.
APPLICANT INFORMATION

Last Name: First Name:

Preferred to be called (i.e. “Michael” as “Mike”):

Address:

Home Phone: Cell Phone:

Email Address:

Are you a Union Member? YES NO

If yes, are you able to get waiver? YES NO

Are you currently in a show, film, TV, etc.? Note:
(Please be specific):

AUDITION INFORMATION
Name of the role you are Dina
Date: September 10, 2017
auditioning for ->
Location: TBD or Self-Taped Audition
If not Self-Taped Audition, please indicate two time slots for audition based on your best availability between 2:00 PM – 7:00PM, September 10, 2017

1st Preferred Time : 2nd Preferred Time:

Please note that each role is the key to this film as a whole, if you Note:
have any major conflicts for workshop and shooting during the
weekends at the month of September & October 2017 with your
other simultaneous projects, please write here ->
Are you willing to accept any
part the director chooses for YES NO
you?
If you are not selected for a role Assistant Cinematographer / YES NO
and would like to work on behind Camera Operator
the camera, please mark (X) Make-up Artist YES NO
here -> Second Assistant Director YES NO
Boom Operator YES NO
Script Supervisor YES NO
Gaffer / Lighting Crew YES NO
Key Grip YES NO
Costume Design YES NO
Focus Puller YES NO
Voiceover YES NO
Vocalist / singer YES NO
Dance Choreographer YES NO
Publicity YES NO
Fight Choreographer YES NO
Casting Assistant Director YES NO

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. I agree that the information I have provided is accurate to
the best of my knowledge and Banzai Multimedia may videotape my audition. If this application leads to onboard, I understand that false
or misleading information in my application or audition may result in my release.
Signature -> Date: