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* 1. Organization name:

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* 2. Contact person:

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* 3. Contact person title:

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* 4. Contact e-mail:

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* 5. What is your organization's 2013 total budget? (Your answer should be one number.)

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* 6. Approximately how many videos did your organization produce in the past 12 months? Please distinguish between in-house and outsourced projects. If you would like to note the total minutes of produced video, there is a space provided.

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* 7. What is the single highest viewership your organization has achieved for an online video in the past 12 months? Please include link to view online.

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* 8. Approximately how many videos does your organization plan to produce in the next six months?

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* 9. How many staff hours per week does your organization devote to the production and distribution of videos? Do you have a full-time employee who is dedicated to video production?

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* 10. What equipment and software are you currently using to produce videos? Please be specific.

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* 11. How would your organization spend $5,000 towards improving your capacity to produce video? Note that this grant is mainly intended for equipment and software upgrades including but not limited to cameras, editing software, lighting kits, tripods, computing power, etc. If you have specific products in mind, please include model number or link to view product online, if applicable. However, if you know you need certain types of products, but would like more guidance on specific models, that's OK!

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* 12. Are you (or the person most responsible for producing video) interested in participating at least once a month in an online forum where LCL! participants can privately share draft projects, get feedback and ask questions?

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* 13. Some organizations may be selected to attend a two-day intensive video production training workshop at UCLA in October. While Atlas will cover curriculum fees and housing, if your organization is selected will you be prepared to cover transport costs?

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* 14. In addition to the L.A. workshop training, this program provides a 1-2 day on-site training visit at your headquarters from an expert filmmaker contracted through Taliesin Nexus. What would you like a visiting filmmaker to emphasize during your site visit? (e.g. provide hands-on guidance on a specific project currently in production, give a broad overview of key tasks associated with video production, spend a majority of the time giving in-depth training on one or two key areas such as...) Also, can you commit to having a minimum of two employees attend this training?

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* 15. Please provide links to your organization's best video work (up to 3 videos).

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* 16. If you would like to share anything else about your organization and/or your plans to use video to achieve your mission, please describe below.

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