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APPLICATION FORM<br />
APPLICANTS DETAILS<br />
Applicant Name:<br />
Date:<br />
Address:<br />
Email:<br />
Daytime Tel no:<br />
Mobile:<br />
AGENTS DETAILS<br />
Agent Name:<br />
Email:<br />
Address:<br />
Daytime Tel no:<br />
Mobile:<br />
COMPANY DETAILS<br />
Agent Name:<br />
Email:<br />
Address:<br />
Daytime Tel no:<br />
Mobile:<br />
I agree to become a member of the<br />
Screen Directors Guild of Ireland and<br />
listed as a member on the official <strong>SDGI</strong><br />
member record.<br />
I provide my consent for <strong>SDGI</strong> to publish<br />
my personal contact details on the <strong>SDGI</strong><br />
website/directory Yes No<br />
OR<br />
I would like my personal contact details<br />
to remain care of <strong>SDGI</strong> Yes No<br />
Applicant Signature:<br />
I consider myself to be a director working<br />
in and/or available for work in the following<br />
areas (please tick):<br />
Animation<br />
Short Film <br />
Commercials<br />
Television<br />
Entertainment <br />
Corporate/Promo Television Drama<br />
Documentary<br />
Television Soap<br />
Feature Film<br />
Video Games<br />
Music Videos Video Art<br />
Date:<br />
I consent to have my website<br />
address<br />
linked to <strong>SDGI</strong> website.<br />
Method of Payment<br />
Cheque<br />
Standing Order<br />
Please return completed application form to Liz Dodd, Executive Administrator,<br />
<strong>SDGI</strong>, Curved Street, Temple Bar, Dublin 2 Tel: 01 6337433 Email: liz@sdgi.ie<br />
STANDING ORDER MANDATE<br />
Members Bank Details<br />
Bank:<br />
Name (s)of Account Holder(s):<br />
Account No:<br />
Signed:<br />
Address:<br />
Sort Code<br />
– –<br />
Amount<br />
€105.00<br />
Please make a payment on receipt of this instruction and thereafter on 31st of January.<br />
Date:<br />
Crediting Bank Details:<br />
Bank of Ireland, Camden<br />
Street, Dublin 2<br />
Account Name: <strong>SDGI</strong><br />
A/C No: 88935715<br />
Sort Code: 90-01-13
ABOUT YOUR WORK<br />
Please provide Directing Credits for works completed and broadcast/screened<br />
Title:<br />
Title:<br />
Release Date:<br />
Origin Of Project:<br />
Release Date:<br />
Origin Of Project:<br />
Genre:<br />
<strong>Form</strong>at:<br />
Genre:<br />
<strong>Form</strong>at:<br />
TV Screenings: (Please List all National/International):<br />
TV Screenings: (Please List all National/International):<br />
Festival Screenings:<br />
Festival Screenings:<br />
Awards:<br />
Awards:<br />
Title:<br />
Title:<br />
Release Date:<br />
Origin Of Project:<br />
Release Date:<br />
Origin Of Project:<br />
Genre:<br />
<strong>Form</strong>at:<br />
Genre:<br />
<strong>Form</strong>at:<br />
TV Screenings: (Please List all National/International):<br />
TV Screenings: (Please List all National/International):<br />
Festival Screenings:<br />
Festival Screenings:<br />
Awards:<br />
Awards:<br />
Additional Credits may be included on a separate sheet. Please enclose a short paragraph about yourself for the <strong>SDGI</strong> website.<br />
Affliations<br />
Please indicate if you are a member of any of the following organizations:<br />
DPRS SIPTU IPSG SPI<br />
Our Affliation Guilds:<br />
DGA DGC ASDA BECTU SGDNZ
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