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One World Media CAN Mezzanine
32-36 Loman StreetLondon SE1 0EH
+44 (0) 20 7922 7941
www.oneworldmedia.org.uk
One World Media Production Fund Application FormRead the Production Fund guidelines and our Fair Filming guidelines before completing this form. Completed form (excluding Equal Opportunities Monitoring Form, p5-6) must not exceed 5 sides of A4 (minimum font size 10).
Name Telephone
Address Mobile
Postcode
Place & date of birth
Nationality
Have you attended a One World Media International Reporting workshop? If yes, please provide the location and date.If no, please provide details on why you have been unable to attend.
Please write a short bio (no more than 100 words)
Students onlyName of institution
City and country of institution
Name of course
At what stage of the course are you?
Name of course tutor
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One World Media CAN Mezzanine
32-36 Loman StreetLondon SE1 0EH
+44 (0) 20 7922 7941
www.oneworldmedia.org.uk
All applicants
Which country will you travel to?
Which medium will you work in and what will be the length of your piece? (radio/film/print/photo)
Total budget of trip in pounds sterling
Expected date of completion of media
What story are you planning to cover? (600 words max.) Provide a clear overview of your story, including details on why it is important and/or timely.
Why are you particularly drawn to tell this story? (600 words max.)
How are you going to tell this story? What style will you use? If working in video, describe two or three sequences you will film. (600 words max.)
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One World Media CAN Mezzanine
32-36 Loman StreetLondon SE1 0EH
+44 (0) 20 7922 7941
www.oneworldmedia.org.uk
What is your target audience and media outlet?
Access. What contacts have you established in the country you want to go to? These might be potential contributors/interviewees, or other contacts who will help to set things up. Please indicate whether they have already agreed to participate.
Safety. Please highlight any significant safety concerns to yourself, any contributors, or anyone else that you may work with. Explain what you will do to mitigate these risks. Please note that we do not fund any stories that are marked “Advice against all travel” on the Foreign & Commonwealth Office website.
Logistics – tell us what equipment you will use, and how you will obtain it. Also tell us the intended length of your trip, estimated number of days needed at specific location/s, and your plans for travel and accommodation when you are in the country.
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One World Media CAN Mezzanine
32-36 Loman StreetLondon SE1 0EH
+44 (0) 20 7922 7941
www.oneworldmedia.org.uk
Budget – please provide a summarised budget for your project, featuring realistic estimates of the main costs (eg. flights, transport in-country, accommodation, any equipment hire). If your budget exceeds £1000 please tell us how you intend to make up the difference should you be awarded a OWM grant.
Media – please provide us with web links of two pieces of media you have produced.
Fair Filming – please read our Fair Filming Guidelines and tell us what you have done or will do to ensure you are exercising fairness and accountability
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One World Media CAN Mezzanine
32-36 Loman StreetLondon SE1 0EH
+44 (0) 20 7922 7941
www.oneworldmedia.org.uk
Equal Opportunities Monitoring Form
Gender Identity: Female Male Non-binary Prefer not to say
Sexual Orientation:Bisexual Gay Man Gay Woman/Lesbian Heterosexual/Straight Prefer not to say
I would describe my ethnic origin as: A: White
British Irish Gypsy or Traveller Any other White Background
B: Mixed White and Black Caribbean White and Black African White and Asian Any other Mixed/Multiple Ethnic
C: Asian or Asian British
Indian Pakistani Bangladeshi Chinese
D: Black or Black British African Caribbean Any other Black/African/Caribbean
E: Other Arab Any other ethnic Group Prefer not to say
Do you identify as disabled? Yes No Prefer Not to Say
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One World Media CAN Mezzanine
32-36 Loman StreetLondon SE1 0EH
+44 (0) 20 7922 7941
www.oneworldmedia.org.uk
If you identify as disabled, how would you describe your disability? Visual Impairment Hearing Impairment/Deaf Physical Disabilities Physical Disabilities Cognitive or learning Disabilities Mental Health condition Other Long term/Chronic Conditions
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