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    CLOSE - Cinema Lab of Shared Experience
    Participant's Survey

    DATA OF THE PARTICIPANT

    Name:

    Surname:

    Gender:

    Pronouns:

    if other, please specify:

    E-mail address:
    The generated PDF of the Entry Form will be delivered to this email address.

    Phone number: (00XX XXXXXXXXX)

    Date of birth: (DD.MM.YYYY)

    Nationality:

    Country of residence:

    City of residence:

    INFORMATION ABOUT PARTICIPANT

    Level of English language:

    Preferred interests:

    A few words about me:
    0/500

    Diet:

    Additional information: (allergies, special needs)
    0/500

    FILM EXPERIENCE

    Did the audiovisual materials you've created have public screenings?

    Were your audiovisual projects on a professional or amateur level?

    What is the average length of the audiovisual projects you co-organized?

    What is the total number of the film projects you have co-organized?

    What is the overall time of your activity in the film field?

    ATTACHMENT

    An idea for a short film script
    - an artistic interpretation of selected themes from the history of Warmia and Masuria and the fate of the local community functioning at the crossroads of Polish, German and Ukrainian cultures.
    0/600

    The generated PDF will be delivered to the email address of the person filling the Participant's Survey.

    "I hereby confirm that I have read The Regulations of the CLOSE - Cinema Lab of Shared Experience..

    "I agree to participate in the Workshops, accept The Regulations of the CLOSE - Cinema Lab of Shared Experience and do agree to personal data processing and presentation for the purposes of the recruitment process and participation in the project, in accordance with Regulation (EU) 2016/679 Of The European Parliament And Of The Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation)."

    Newsletter:
    "I do agree to receiving monthly invitations and information on educational and cultural projects (eg. competitions, workshops, festivals, films reviews) implemented or recommended by the Organisers (sent contents do not contain commercial information) to the e-mail addresses indicated herein."