	Applying students must submit this form and any applicable supporting material five business days in advance of proposed reservation date. The application will be reviewed by the Production Faculty Committee. You will receive notice within three business days.

1.	Are you requesting the Black Box in Kenan Hall or the Sound Stage in the University Film Center?

2.	First Name*

3.	Last Name*

4.	UNCW Email Address*

5.	Student ID (850 #)*

6.	Cell Phone Number*

7.	Semester*

8.

What is this reservation for*

Production

Audition

Rehersal

Other, please specify

9.	Course Name and Number* Include the section

10.	Professor of Course* First and last name

11.	Proposed Reservation Date* These days/times must include all time needed to prepare for shooting and wrap, cleaning, and restoration

12.	Start Time*

13.	End Time*

14.	Reservation Date # 2

15.	Start Time for Date #2

16.	End Time for Date #2

17.	Reservation Date #3

18.	Start Time for Date #3

19.	End Time for Date #3

20.	Setup Count* How many people will be in the room

21.

Indicate if this project will require the following

Grid Access

Moving Set Walls

22.	Describe your design plans for use of space Include paint color, set-dressing, furniture, etc.

23.

Indicate if this project will require the following*
If you have listed stunts, liquids, fire, or other, you must submit a script with scenes to be shot in the Black Box clearly marked and a complete crew list to the instructor of the class and Aaron Cavazos (cavazosa@uncw.edu) in conjunction with this application.

Stunts

Liquids

Fire

None

Other, please specify

24.

I have read the Sound Stage and Black Box rules. I agree to follow these rules and all relevant UNCW and Film Studies Department policies if I am granted access. I understand that failure to comply with Sound Stage and Black Box Rules and UNCW/FST policies may result in loss of equipment and studio privileges, financial penalties, and personal liability for losses, damages, and injuries.

*

I agree