Frontières @ Brussels 2014 Accreditation Form

By filling out this form, you are applying for accreditation to the Frontières International Co-Production Market and providing information for its market guide.

Thank you for taking the time to thoroughly fill out this form as requested. All submitted information will be printed in the Frontières Market Guide unless otherwise specified. If a question field does not apply to your situation, please indicate N/A in the field below.

You will receive approval notification and accreditation fees (80€ until February 14, 120€ after this date) payment instructions within a few days of your application. (Please disregard this if you received a personal invitation.)

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* 1. Please enter your contact information as thoroughly as possible.

Name:

Company:

Address:

City:

State/Province, Country:

ZIP/Postal Code:

Email Address:

Phone Number:

Cellphone Number:

Website:

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* 2. My cellphone number can be listed in the market guide

Yes

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* 3. Please provide your field(s) of operation.

Distribution

Filmmaking

Financing

Institution

Production

Programming

Sales Agency

Service Provider

Talent Agency / Management

Other (please specify)

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* 4. Please provide a short description of your company. (Max 100 words)

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* 5. Please provide the titles of your past productions / acquisitions, including dates (Max 3 entries).

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* 6. Please provide the titles of current productions / acquisitions / clients (Max 3 entries).

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* 7. Please indicate if you wish to also receive an accreditation to the Brussels International Fantastic Film Festival (BIFFF) to have access to festival screenings. A Frontières’ badge does not give free access to the films screening at BIFFF and only a limited number of festival industry badges are issued by BIFFF. Priority will be given to buyers. Please let us know and you will receive confirmation shortly.

Yes, I would like to receive accreditation for both Frontières and BIFFF

No thank you, I am only requesting accreditation for Frontières.

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* 8. For survey purposes, please indicate the number of flights that you take per year (leisure and professional).

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* 9. I declare that I have read the Frontières Terms and Conditions (available here: http://bit.ly/1evE6Zy) and that I fully accept them.

Yes

Thank you for filling out this form. We will get back to you shortly.
Once you click on Done, you will not be forwarded to a confirmation page, but we will be receiving the information.