Name:
Birthdate (mm/dd/yyyy ):
Full Address:
Email Address:
Home Number(xxx-xxx-xxxx ):
Mobile Number(xxx-xxx-xxxx ):
Best time to contact you is:
How did you hear about the F-Word program?
Former F-Word Participant
Chica Luna's Website
Chica Luna's E-Newsletter
Another Community Organization
Friend
Forwarded Email
Chica Luna Staff/Board Member
School
Listserv/Group
MySpace or Facebook Advertising
Other
Please tell us what compelled you to apply for the F-Word: Media Justice Film/Video Lab? What do you find most appealing about this program? What would you like to achieve by participating in the F-Word? (250 words or less )
How would you define yourself?
What are your strengths and challenges?
Describe a moment when you felt powerful.
Describe a moment when you felt powerless.
How do you define support? When in need of it, whom do you go to for support?
Why are you interested in film as opposed to writing a book or a play?
Has a film influenced you? Name the film and explain in what way did it influence you.
What experiences, skill and/or talent will you bring to the F-Word's intense collaborative learning environment?
Chica Luna’s mission is to support and develop women of color in popular media. How will participating in the F-Word contribute to your success as a socially conscious filmmaker?
How can the arts & media be used as a tool for social change? And how would you use your films for social change?
Describe how would the media you will (or have created) change one stereotype assigned to women of color?
Define the specific community that you belong to (i.e. Korean, working class, New York, LGBT, Muslim, etc.). Describe how popular media portrays your community. List one key issue affecting your communities and describe how television, film and radio may contribute to the problem. (ESSAY: 500 words or less )
Where do you see yourself in 5 years?
Please use this space to tell us anything else about yourself you think we should know.
Please don't forget to send all application materials listed below to Karly at: fword@chicaluna.com , in order for your application to be valid.
A letter of recommendation (i.e. from teacher, parent, counselor, friend, community leader, spiritual advisor, etc.)
A short story (500 words or less) based on a significant real-life or fictional event. This short story should have a plot with a clear beginning, middle and end. Does not have to be autobiographical.
A non-refundable application fee of $50.
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