Chrysalis Productions - Printable Grant Form

Chrysalis Productions Grant Program

Date: ___________________________

Production Company: ______________________________________________________

Year Founded: ___________________________

Executive Producer(s): _____________________________________________________
________________________________________________________________________

Director: ________________________________________________________________

Primary Contact Person: ____________________________________________________

Address: ________________________________________________________________
________________________________________________________________________

City: _________________________ State: _____________ Zip: _____________

E-mail: __________________________ Phone: __________________________

__________________________ __________________________

Website: ____________________________________________________________

Date of any previous application for the Chrysalis Grant and project name:

________________________________________________________________

Name and address of Tax-Exempt 501 (c) (3) Sponsoring Organization:

________________________________________________________________

NOTE: Please submit a letter from the 501 (c) (3) organization listed above requesting funds on your behalf and agreeing to supervise your project. Proposals will not be accepted without this sponsorship letter.

Project Details:

Probable Film Title: ______________________________________________________

Projected Length: ___________________ Format: ___________________

Total Project Budget: ___________________

Describe the film's subject precisely and briefly. Why is this film needed?

Discuss your conceptual ideas and technical approaches. What will the film look like? How are ideas and information presented?

Who is your audience? How do you plan to market, broadcast and plan for the remaining aspects?

At what stage is the project now? What is your timetable and plan for the remaining aspects?

Describe your proposed plans for use of this grant should you be selected.

Profiles of Key Staff:

Please provide brief bios for all key staff, including details on any past projects.

** Please send a DVD with up to 15 minutes of clips from the current project, as well as four copies of your application form.

NOTE: Applications must be postmarked by no later than April 1st or October 1st to be considered at the meeting following the deadling. The board of directors meets in May and November to consider grant applications.