Application Form for Admission (Before mailing the application form, it is mandatory to register online)

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1 MOVING IMAGES EDUCATIONAL TRUST S INSTITUTE OF MOVING IMAGES An Autonomous Centre for Film Studies Application Form for Admission (Before mailing the application form, it is mandatory to register online) Admissions, Institute of Moving Images, New M.A. Building, Gokhale University Campus, 846, Shivaji Nagar, BMCC Road, Deccan, Pune , Maharashtra, India Paste here your passport size color photo Online Registration No. (Mandatory and to be filled by applicant) PROGRAM APPLYING FOR (Please choose any one program & tick course start month) ADVANCED DIPLOMA Film Direction (18 Months Full-time including internship) Cinematography (18 Months Full-time including internship) Film Editing (18 Months Full-time including internship) Producing (18 Months Full-time including internship) Script Writing (18 Months Full-time including internship) September intake 2015 September intake 2015 September intake 2015 September intake 2015 September intake 2015 January intake 2016 January intake 2016 January intake 2016 January intake 2016 January intake 2016 DIPLOMA IN FILMMAKING Fiction for Television (1 Year Full-time including internship) Documentary (1 Year Full-time including internship) September intake 2015 September intake 2015 January intake 2016 January intake 2016 PERSONAL DETAILS Please fill out in BLOCK LETTERS Surname Mr. Mrs. Miss Dr. First Name Father s / Husband s / Guardian s Name Date of Birth Residential Address Gender Nationality City Country Telephone (With STD/ISD code) Post Code / Zip code Mobile ACADEMIC & EMPLOYMENT DETAILS Please fill out in BLOCK LETTERS Academic Qualification Current Occupation (If employed, describe the area in which you are working & your position) Office Address & Telephone No. (with STD/ISD code)

2 GENERAL Institute of Moving Images Previous Film Industry Experience Where do you think your interests lie at present Extensive Some Little Non Direction Production Writing Editing Camera Documentary Where did you hear about us? Father s / Husband s / Guardian s Occupation Annual Income of the Family Who is going to finance your education at IMI? Parents Self Bank Loan Are there any special medical needs that we should be aware of? No Yes if yes, please specify CHECK LIST Advanced Diploma & Diploma Course applicants need to submit all the followings: (Without the followings attachment your application cannot be processed) 1. Self attested copies of College / School Certificates. 2. Letter of Recommendation Provide letters of recommendation from two eminent persons, unrelated to you, who know you well. 3. Registration Fees Details Online Payment / NEFT Order No. Dated Bank Name 4. A photocopy of the transaction receipt for payment of non-refundable Registration Fee of Rs.2,500/- through NEFT / IMI Online Payment Gateway in favour of Institute of Moving Images, A/c No: , HDFC Bank Ltd., Malad (w) Branch, Mumbai, IFSC Code: HDFC A photocopy of the Online Registration Notification sent by IMI to the applicant 6. Statement of Purpose Please tell us all in one page: (a) about yourself, how you view yourself and how others view you. (b) about your creative influences. (c) why you wish to study film and (d) how you think you will use your experience at IMI towards your future goals. 7. Essay Any two of the followings: (a) Which literature would you like to interpret for big screen and why? (b) Of all the celebrated film makers, whose style would you most like to emulate? (c) Write a proposal for a short film you would like to produce (it need not be the film you make in IMI). Describe the story line, the cast and other creative elements in the production of the film. (d) List three ideas for 3 documentary films, what the films would be about and the questions films would address. (Must for all the applicants applying for Diploma course in Documentary film making.) 8. Creative Portfolio Please submit one of the followings as a sample of what you believe to be the best example of your creative work: (Note that the materials submitted with your application will not be returned. Audio video materials should preferably be sent on DVD) - Present any story in series of still photos. - A DVD / web link to a short film you have made. - A short story or a script or a photography portfolio or any published article. - A project you have done that reflects your interest in film making or theater or photography or litereture. - Evidence of creative ability in fiction writing (Must for all the applicants applying for Advanced Diploma in Screen writing) By signing this Application Form for Admission, I hereby declare that the information I have provided above are correct to the best of my knowledge. I have read and agreed to abide by the IMI admission and fee payment policy. I have also read, understood and signed the IMI terms and conditions attached in next two pages. (After posting this Application Form to IMI by Courier, please also Intimate us by imi_filmschool@yahoo.com) FOR OFFICE USE ONLY Student Code : Date of Interview : Remarks Admission Status : Approved By :

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