First Name *
Last Name *
Apartment / Floor / Suite Number
ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING AMERICAN SAMOA FEDERATED STATES OF MICRONESIA GUAM MARSHALL ISLANDS NORTHERN MARIANA ISLANDS PALAU PUERTO RICO U.S. MINOR OUTLYING ISLANDS VIRGIN ISLANDS ARMED FORCES AMERICAS ARMED FORCES ARMED FORCES PACIFIC ALBERTA BRITISH COLUMBIA MANITOBA NEW BRUNSWICK NEWFOUNDLAND AND LABRADOR NOVA SCOTIA NORTHWEST TERR. NUNAVUT ONTARIO PRINCE EDWARD ISLAND QUEBEC SASKATCHEWAN YUKON
What Would You Like to Do? *
Both Mentoring and Performing Interest Me!
Which Program Are You Signing Up For? *
Script to Stage (5th grade program)
P.O.V. Point of View (High School Program)
If you are signing up to mentor a high school student in P.O.V., what aspect(s) of filmmaking are you interested in mentoring? Note: You can do more than one!
Director of Photography (DP) Mentor
These next few questions help us place you in a school near your work or home, with sessions on a day you can actually make, typically around midday. Efficiency!
Days Available to Mentor? *
N/A (I’m interested in performing and know I’ll be contacted on an as needed basis)
Neighborhood Preference? *
Santa Monica / Venice
Silver Lake / Echo Park / Downtown
San Fernando Valley
Wilshire Corridor / Mid-City
South Los Angeles
I’ll go anywhere in LA you need me! (All of the above apply)
San Francisco Bay Area
New York City (Midtown West)
New York City (East Village)
Now that we have that out of the way, we’d like to get to know you a bit better! These questions help us understand our volunteer base and (upon occasion) fill specific needs a program may have.
What Kind of Work Do You Do? (e.g. Actor, Editor, Writer, Accountant, Art Director, etc.) *
Where Do You Work? If Self-Employed or Primarily Work Gig-to-Gig, Please Indicate That. *
What is Your Highest Level of Education? *
College Degree High School Diploma / GED Some College Master’s Degree (non-M.F.A.) Master of Fine Arts (M.F.A.) J.D. Doctorate Degree (Ph.D.)
If You Attended College, Where Did Attend and What Year Did You Graduate? (e.g. UCLA, 2004)
Did Someone Refer You to Us? If so, who can we thank?
Oh, real quick, do either of these statements apply to you?
College Chapter members!
I attend a Young Storytellers College Chapter school and will be mentoring with a group of students from my school, which is…
I work at a Young Storytellers partner corporation and will be mentoring with a team of people from my office, which is…
Great! The next few questions help us assemble a diverse cast for our Big Shows and Movie Makers projects. If you are only interested in mentoring, please select N/A or “Decline to State.”
Female Male Other
What Is Your Age Range? *
18-24 25-31 32-38 39-45 45+ N/A – I’m only interested in mentoring
Have You Attended One of Our Awesome, Fun, and Informative Training Sessions? *
Yes, I’ve attended Mentor training!
No, I still need to attend Mentor training.
Have You Submitted a Background Check With Us? *
Yes, I’ve submitted a background check!
No, I haven’t yet submitted a background check.
I’m interested in performing, so I don’t need to submit a background check!
Legal stuff. We promise to keep it as short as possible.
Thank you for voluntarily participating in the Young Storytellers Program (the “Program”) with the Young Storytellers Foundation (“YSF”). Your participation in the program (or the participation of your minor child) may involve many aspects of our work, but in being involved in the program, you may also create, modify, adapt, participate in, or otherwise work on various creative projects. In order to protect our interests, and to clearly define your rights related to your participation (or the participation of your minor child), we need you to carefully consider and sign this Release. This is an important legal document, so please take the time to fully understand it before signing. Any communications or material you create, provide to YSF or are otherwise involved in will be treated as non-confidential and will be owned by YSF. This obviously includes any creative work, but also includes less obvious things like questions, comments, ideas, images, writings, music, sounds, audiovisual works or effects, artwork, design elements, graphics, suggestions, concepts, notes or other materials (we will refer to all of these things as “Program Materials”). By signing this Release, you agree to transfer and assign to YSF all rights in the Program Materials forever. This means that YSF will have the exclusive right to do anything with those Program Materials without paying you anything, including the right and license to use, reproduce, modify, adapt, publish, translate, create derivative works from, incorporate into other works, distribute, sub-license, perform, display and otherwise exploit those Program Materials, in all languages and throughout the universe, in any form, media or technology now known or hereafter devised. By signing this Release, you acknowledge and expressly agree that you will not receive any financial or other consideration in connection with our use of the Program Materials, including, without limitation, credit. Notwithstanding the foregoing, you agree that if we have specifically offered a credit in exchange for certain submissions, our agreement must be in writing, and all aspects of that credit (including determination of eligibility) will be at our sole discretion and any failure to provide credit will be a non-material failure and will not entitle you to damages or any relief at law or in equity (without limitation you will not be entitled to any injunctive or equitable relief). In connection with your participation (or the participation of your minor child) in the Program, you hereby additionally grant to YSF permission to use your name, photographic and/or video likeness, voice, information concerning you and statements made or information supplied by you, each in whole or in part, in any and all present and future media worldwide and in any channel of marketing, solely in connection with the display, fulfillment, advertising, and/or promotion of the Program, and in connection with these manners you hereby release YSF, and all of its affiliates, employees, and other agents, from any and all liability associated with our use of the foregoing. This release is a legal document that affects your legal rights, and its interpretation shall be governed and construed in accordance with the laws of the State of California, exclusive of its provisions on conflicts of laws. You also agree that the exclusive forum and venue for any dispute relating to this Release or your participation (or the participation of your minor child) in the program shall be the State or Federal Courts located in Los Angeles County, California. By checking the box below, you agree to and accept any and all of the conditions and terms stated above. Checking this box is the same as signing a legal document. If the person signing this release is under 18 years of age, a parent or guardian must sign.