Fellowship Application Form Fellowship Application Form 2021 Please refer to the Guidelines before completing the following application form. 1Personal Details2Career History3Budget/Timeline4Development Proposal5Supporting Documents6 Personal DetailsName* First Last Email* Enter Email Confirm Email Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Mobile*Are you of Aboriginal or Torres Strait Islander heritage?* No Yes, Aboriginal Yes, Torres Strait Islander Yes, both Aboriginal and Torres Strait Islander Website (if applicable) Website & Social Media LinksFacebookInstagramLinkedInWebsiteOther Career HistoryJob Title* Company* Sector*(Select all that apply) Exhibition Distribution Writer Director Producer Production, other Post-production Broadcasting Government Agency Education / Training Other If other, what sector? Within this sector, what field? How many years have you worked in the screen industry?* Short bio (up to 200 words)* Budget and TimelineTotal cost of proposal*Amount being requested from the NMF?*Please enter a number less than or equal to 20000.Personal financial contribution to the project*Amount being requested from other funding bodies*Requests to other funding bodies (if applicable)Funding bodyAmountStatus Proposed Start Date DD slash MM slash YYYY Proposed Completion Date DD slash MM slash YYYY Please download and fill out the NMF budget and timeline templates (available via FAQ and guidelines pages). You will be asked to upload these documents in the 'Supporting Documents' section. Development Proposal DetailsProposal Summary*Provide a brief outline (100 – 150 words) of your professional development proposal Note: this may be used for promotional purposes.Proposal Description & Proposal Outcomes Your proposal has two components and can be supplied as either written documents or video pitches: Proposal Description (300-500 word document or 2-3 minute video) - a succinct description of your proposal including evidence of your ability to execute the project. Proposal outcomes (500-800 word document or 3-5 minute video) – how the Natalie Miller Fellowship would contribute to your professional development and how it would benefit the wider screen community. Video pitches should be supplied as links (e.g. YouTube or Vimeo). Written documents should be supplied as PDFs.How would you like to submit your Proposal Description and Proposal Outcomes?* Written documents Video pitches Link to Proposal Description video:*Note: please check the URL you provide works by opening in a Private Browsing window before submitting* Password (if applicable)Password (if applicable) Link to Proposal Outcomes video:*Note: please check the URL you provide works by opening in a Private Browsing window before submitting* Password (if applicable)Password (if applicable) Proposal Description*A succinct description of your proposal (300-500 words) including evidence of your ability to execute the project. Drop files here or Select files Max. file size: 32 MB. Proposal Outcomes*Detailed outline (500-800 words) of how the Natalie Miller Fellowship would contribute to your personal development and how it would benefit the wider screen community. Drop files here or Select files Max. file size: 32 MB. Supporting DocumentsResume / CV*Please upload your current Resume/CV including details of business/creative output, education and employment history Max. file size: 32 MB.Proposed budget and timeline*Upload your filled-out budget and timeline documents. Drop files here or Select files Max. file size: 32 MB. Confirmation Letter (if relevant)Please include confirmation of acceptance into a professional opportunity (i.e. mentor or internship) Drop files here or Select files Max. file size: 32 MB. Reference Letters*Include a minimum of 2 signed letters of reference supporting your proposal Drop files here or Select files Max. file size: 32 MB. Any additional supporting documents Drop files here or Select files Max. file size: 32 MB. Preview Your SubmissionPlease use the 'Previous' and 'Next' buttons to make any changes if required.{all_fields}