whites_equipment_deferral_filmpool_app_2012

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Saskatchewan Filmpool Cooperative and William F. White Inter national Inc. Equipment rental deferral application form

301 - 1822 Scarth Street, Regina, SK, S4P 2G3, Canada 306.757.8818 - fax 306.757.3622 - production@filmpool.ca - filmpool.ca

Name: ___________________________________________________________________ Date: ___________________________________________________________________ Project title: ___________________________________________________________________ Production location: ___________________________________________________________________ Production schedule: ___________________________________________________________________ (up to one year from application)

___________________________________________________________________ ___________________________________________________________________

Requested equipment: ___________________________________________________________________ (maximum deferral $2500.00) Lighting and grip equipment only. Not eligible: Chapman and Fisher dollies remote heads and cranes generators Camera Car expendables any speciality equipment

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

I have been trained or have had previous experience with this equipment I understand that I will have to insure this equipment for the duration of my rental I have filled out the Filmmakers’ Production Assistance Program application Certificate #: WFW2011-32 § document revised September 2012


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