Name *

First Name

Last Name

Phone

(###)

###

####

Are you interested in being an extra in the film? *

If so, please answer the following questions.

Yes

No

How would you describe yourself? Mark all that apply.

White

Black or African American

American Indian or Alaska Native

Asian

Hispanic or Latin American

Native Hawaiian or other Pacific Islander

Middle Eastern

Do you have any previous experience as an actor or extra?

Previous experience is not required.

Yes

No