Application for classification of music DVD's, educational films and children's films

[Regulation 12]

The Film and Publication Board may refuse to process your application if this form is not fully completed

Reg Office No.:

DATE OF APPLICATION

DATE RECEIVED (Office use)

DATE OF EXEMPTION

BASIS OF EXEMPTION

APPLICANT

POSTAL ADDRESS

POSTAL CODE

CONTACT PERSON

TEL

FAX

E-MAIL

TITLE (for distribution/exhibition)

PREVIOUS TITLE (if different)

ORIGINAL

RE-RELEASE

FORMAT

35MM

VIDEO

DVD

VCD

CD-ROM

OTHER

RUNNING-TIME IN MINUTES, AS SUBMITTED

SUBJECT OR GENRE

DIRECTOR

CAST INCLUDES

LANGUAGE

ORIGINAL

DUBBED

SUB-TITLED

SIGNED

DATE

CAPACITY