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* 1. First Name

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* 2. Surname

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* 3. Address and contact details

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* 4. Where will your film(s) be shown in Bradford District?

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* 5. If you have a venue, please tell us about it. (350 words max)

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* 6. Describe why there is a need for a social cinema where you live.
How have you identified this? (350 words max)

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* 7. What social issue will your cinema be exploring? How will social cinema make a difference in your community? (350 word max)

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* 8. Who are your intended audience? Please tick all relevant boxes.

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* 9. How will you ensure you will attract diverse audiences?

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* 10. Tell us about the types of films you would like to screen.
Explain why you have chosen these.

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* 11. What are the discussions/activities that may develop as a result of having
a social cinema in your local area?

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* 12. What skills/experiences do you hope to learn/develop from your social cinema?

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* 13. How many viewings would you like funding for?

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* 14. What would you spend your support money from The Leap on?

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* 15. Referees: Please provide us with details of two referees who know about your film idea
and would be willing to provide a reference. Please check before naming them.
Family members are not permissible.

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* 16. How did you hear about us? Please tick one of the categories below.

(This will help us identify effective communication channels.)

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* 17. Do you have any health limitations we need to be aware of?

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* 18. If YES are there any reasonable adjustments we can make for you?

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* 19. I confirm that, as far as I know, all the information I have given on this application is true and correct. I understand that you may ask for more information at any stage of the application process. (please enter your name below to confirm)

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