You are on page 1of 5

Film Industry Welfare Trusts

ACTOR PREPARES - MUMBAI


The School For Actors

Staple recent
passport size
photograph.

1st Floor, Film Industry Welfare Trust House, next to Ajivasan hall
Near SNDT Womens College, Juhu Road, Santacruz [W]
Mumbai 400 049
e-mail: info@actorprepares.net
Phone: 2660 6180 /2660 5659/652 61232 Toll Free: 1800 209 1231

Please fill in this form in neat handwriting / or type, complete in all respects.
Please be precise & factual. Send in the form to above mentioned address
with a Demand Draft / Pay order of Rs. 250/- payable at MUMBAI, in favour
of FILM INDUSTRY WELFARE TRUSTS ACTOR PREPARES.
___________________________________________________

PERSONAL INFORMATION
NAME (IN FULL BLOCK LETTERS)
Mr./ Mrs./ Ms.
Important note: The name mentioned above will be printed on your Diploma.

PRESENT ADDRESS:

City:

Pin Code:

State:

Country:
Email:
Tel. Home:

Mobile:

PERMANENT ADDRESS:

City:

Pin Code:

State:

Country:
Film Industry Welfare Trusts Actor Prepares, 1st Floor, Film Industry Welfare Trust House, next to Ajivasan
hall, Near SNDT Womens College, Juhu Road, Santacruz [W], Mumbai 400 049
www.actorprepares.net

Fathers Name:
Mothers Name:

DATE OF BIRTH:
Day:

Month:

Year:

Height:

Age:

Weight:

MARITAL STATUS:
Married
(tick whichever applicable)

Unmarried

No. of children

In case of emergency, notify [next of kin]


NAME & ADDRESS:

Tel. Home:

Business:

Mobile:

EDUCATION:
Higher Secondary

Graduate

Post Graduate

(tick whichever applicable)

Other educational qualification [please specify ] :

Final year of study:

Board/University:

Percentage of
Marks obtained:

Principal
Subjects:

[Minimum requirement is 10+2. This requirement could however be relaxed for exceptionally
talented actors.]
Film Industry Welfare Trusts Actor Prepares, 1st Floor, Film Industry Welfare Trust House, next to Ajivasan
hall, Near SNDT Womens College, Juhu Road, Santacruz [W], Mumbai 400 049
www.actorprepares.net

EMPLOYMENT HISTORY:
What is your current occupation?
(tick whichever applicable)

Studying

Employed

In case employed, then please give details of your most recent employment:
Date of Employment:
Employers Name & Address:

Full Time employment

Part Time employment

Position
Held:

Duration:

(tick whichever applicable)


Annual Income:

ARE YOU INVOLVED WITH THE PERFORMING ARTS / ENTERTAINMENT INDUSTRY?


Yes

No

(tick whichever applicable)

IF YES THEN IN WHAT CAPACITY:

HOW DID YOU KNOW ABOUT ACTOR PREPARES


(tick whichever applicable)
Friends & Relatives
Actor Prepares Web page
Media/Editorial/Advertisement
Promotional Sms/Email
Other sources [please specify ]

Film Industry Welfare Trusts Actor Prepares, 1st Floor, Film Industry Welfare Trust House, next to Ajivasan
hall, Near SNDT Womens College, Juhu Road, Santacruz [W], Mumbai 400 049
www.actorprepares.net

ACTING EXPERIENCE [Theatre, Film, Television]

Mention your previous experience as an actor (notable roles played etc.):

ADDITIONAL INFORMATION

Previous study/training in Theatre/Dance/Music/Visual Arts/Other Skills:

Explain briefly why you want a career in Theatre, Film or Television and your plans after
training:

Any additional information you would like to offer:

Film Industry Welfare Trusts Actor Prepares, 1st Floor, Film Industry Welfare Trust House, next to Ajivasan
hall, Near SNDT Womens College, Juhu Road, Santacruz [W], Mumbai 400 049
www.actorprepares.net

KNOWLEDGE OF LANGUAGES:
Mother tongue:
Languages spoken:
Languages read:
[Note: Medium of teaching will be Hindi and English]
Are you a citizen of India? Yes
(Tick whichever applicable)

No

If NO then what is your nationality? :

Passport Details
Passport #:

D.O.I.:

D.O.E.:

SIGNATURE: ________________________

PLACE:
DATE:
Course start date and year
you wish to apply for:

Please attach the following with your application form:


1. Xerox of your valid passport [in case of overseas students]
2. School leaving certificate / copy of your passport stating your date of birth.
3. Medical fitness Certificate.

Film Industry Welfare Trusts Actor Prepares, 1st Floor, Film Industry Welfare Trust House, next to Ajivasan
hall, Near SNDT Womens College, Juhu Road, Santacruz [W], Mumbai 400 049
www.actorprepares.net