Name *

First Name

Last Name

Phone *

(###)

###

####

What is your race/ethnicity? *

African-American/Black

Latino/Latinx/Mestizx

Asian/Pacific Islander

Caucasian/White

Native American/Indigenous

Middle Eastern/Arab

Bi-racial/Multiracial

Other

What is your gender? *

Cis woman

Cis man

Nonbinary

Trans man

Trans woman

Two- Spirit

Other

Are you currently experiencing homelessness? [This could also mean couch surfing, staying with someone temporarily, or sleeping in a place that is not safe or meant for human habitation]. *

Yes

No

Are you a Veteran or have you served in the Military? *

Yes

No

I'm not sure

Have you or your family ever experienced any of the following? Check all that apply.

Gender based violence

Racial discrimination

Incarceration

Foster care

Undocumented or citizenship status in transition

Workplace discrimination

Microaggressions

Homelessness

Veteran or Military Service

None of the above

Other

Choose not to answer

What year did you previously participate in the BIPOC Screenwriting Lab?

2020

2021-2022

2022-2023

2023-2024

If selected, I commit to attend all sessions that BIPOC Sci-Fi Screenwriting Lab Special Edition convenes at the times and dates described in this application form. *

Yes

No

Choose Not to Answer

Have you written a short film before? *

Yes

No

I started one but did not finish

What additional aspirations do you have in film/television? *

Directing

Producing

Cinematography/Camera Dept.

Production Design/Art Dept.

Editing

Sound

Marketing

Acting

Other

To participate in the program you need to agree with our terms and conditions. *

I understand that Justice for My Sister is working with a panel of readers to review applications, and there is a chance I might not be selected, due to limited capacity.

I agree that all the information I have provided is transparent, representative and true. I have voluntarily submitted my own original material to Justice for My Sister for the sole purpose of review for acceptance to the BIPOC Sci-Fi Screenwriting Lab Special Edition.

I agree to complete the post survey provided by JFMS staff upon completion of the program.

If accepted, I agree to Justice for My Sister publishing my logline, bio and headshot photo to announce my participation in the Lab once I’ve completed my onboarding process.

I understand that upon completion of the lecture series, I am eligible for additional mentorship, and this is contingent upon review from a selection committee.

I consent to full communication regarding my progress within the program with Justice for My Sister funders, including but not limited to: my demographic information, justice system involvement, service assessments, services information, and my program outcomes on a need-to-know basis.