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IGNITE YOUR INTEREST IN FILM
OCTOBER 2026
Hertsmere Screen Futures Application Form
Child Name:
Young Person Age
Date of birth
Parent/guardian name
Parent/Guardian Email:
Parent/Guardian Mobile phone:
Home Postcode
What interests you most about Film & TV
Acting
Directing
Camera
Editing
Sound
Production
Screenwriting
Costume
Hair & Makeup
Set design
Lighting
Special effects
Producing
Marketing
Not Sure Yet
Why would you like to take part in Hertsmere Screen Futures
What Would You Most Like To Gain From This Experience
Does your child have any additional needs or support requirements that would help us provide the best possible experience
YES
NO
If YES please tell us more
Does Your Child Have Any Of The Following
Autism
ADHD
Dyslexia
Dyspraxia
Learning Difficulties
Physical Difficulties
Hearing Impairment
Visual Impairment
Anxiety
Other
Prefer Not To Say
Is Your Child Currently Supported by
EHCP
SEN Support
School Pastoral team
CAMHS
Other Support Services
None
Prefer Not To Say
Are There Any Adjustments We Could Make To Help Your Child Get The Most From This Programme
Which Of The Following Would Normally Make It Difficult For Your Child To Access Opportunities Like This
Cost
Transport
Anxiety
Confidence
Disability
Neurodiversity
Caring Responsibilities
Lack of Opportunities
None
Other
If you are happy to tell us more, please explain any barriers your child faces
Would this opportunity have been possible without the funded place
YES
NO
UNSURE
Medical conditions
Allergies
Medication
GP Name
Permissions to administer First Aid
YES
NO
Photography and filming consent
YES
NO
Screening Permissions
YES
NO
Marketing Consent
YES
NO
Agree to terms and conditions
YES
NO
Why should you be selected to take part in Hertsmere Screen Futures
How did you hear about this programme
School
Hertsmere Council
Parent
Social media
Brilliant Film Academy
Friend
Other
Thank you for contacting us.
We will get back to you as soon as possible.
Oops, there was an error sending your message.
Please try again later.
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