Audiovisual Women | Application Form

Note *

By filling out this form, you will be registered as an applicant for Audiovisual Women 2023. (Data protection: The following personal data will be collected, processed and stored by the Erich Pommer Institut for the expression of interest in Audiovisual Women program. By submitting the completed form, you consent to the Erich Pommer Institut processing and storing the data collected. You can revoke this consent at any time with effect for the future by sending an e-mail to datenschutz@epi.media).

How did you find out about this program?

Personal and Contact Information

First Name

Surname

Nationality *

International phone number (mobile) *

E-mail address *

Are you a member or alumna of:

EWA Network

WIFTI

EAVE

OtherOther

Assistant's Information

Copy my assistant?

No

Yes

Assistant's Name

Assistant's e-mail address

Assistant's international phone number