4th AACTA Awards Juror Expression of Interest Form

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Name:

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AACTA Membership Number:

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Industry Accreditation/Role:

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Website/IMDb Profile:

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Contact Phone Number/Mobile:

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Email Address:

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Postal Address:

(Note: This is where jury packs will be sent to - it can be a company, private or P.O. box address.)

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State:

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Postcode:

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Jury Preferences:

Feature Film Pre-Selection (July)

Short Fiction Film & Short Animation (July-August)

Feature Length Documentary (August-September)

Documentary Television (August-September)

Television Drama (September-October)

Television Comedy & Light Entertainment Series (September-October)

Reality Television Series (September-October)

Children's Television Series (September-October)

(Please indicate up to 8 jury preferences, with 1 being your first preference.)

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Are you associated with any production/s that may be a 2014 entrant?

Yes

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If so, please provide details of the production/s and your role/involvement:

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Have you previously been a juror for the AFI | AACTA?

Yes

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Name:

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AACTA Membership Number:

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Industry Accreditation/Role:

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Website/IMDb Profile:

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Contact Phone Number/Mobile:

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Email Address:

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Postal Address:

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State:

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Postcode:

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Jury Preferences:

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Are you associated with any production/s that may be a 2014 entrant?

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If so, please provide details of the production/s and your role/involvement:

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Have you previously been a juror for the AFI | AACTA?

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If so, please advise what year/s and what jury/juries: