This form is approximately 3-4 print pages. You may also download the application form in PDF format.
| PROJECT TITLE: | ________________________________________________________ |
| PROJECT DIRECTOR: | ________________________________________________________ |
| ADDRESS: | ________________________________________________________ |
| PHONE NUMBER(S): | ________________________________________________________ |
| E-MAIL ADDRESS(ES): | ________________________________________________________ |
| VIDEO SAMPLE SUBMITTED? [ ] Yes [ ] No |
PROGRAM DESCRIPTION (include content, format, length, and target audience; use only this space):
| Producer: | ________________________________________________________
________________________________________________________ |
| Director: | ________________________________________________________
________________________________________________________ |
| Writer: | ________________________________________________________
________________________________________________________ |
(List each budgetary item related to the project, along with the formula for determining cost; note which items are to be paid for by the KET Fund for Independent Production grant):
| Item | Cost | KET Fund |
| ____________________________________________ | __________ | [ ] |
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| Total KET funds requested: | _____________ |
| Activity | Activity Completion Date |
| __________________________________________________ | ____________ |
| __________________________________________________ | ____________ |
| __________________________________________________ | ____________ |
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| Project to be completed by: | ______________ |
Proposals requesting more than $15,000 must include a video sampler that should be less than 10 minutes in length. The sampler must be DVCam, MiniDV, or DVD.
| Mail the application form to: | KET Fund for Independent Production 600 Cooper Drive Lexington, KY 40502-2296 |