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Please complete this form as openly and accurately as possible and select dates for your introduction call with the producers..
First name
Last name
Phone
Email
Current Home Town
Are you currently in therapy?
*
Required
Yes
No
Would your barber be okay with us filming you at their shop
*
Required
Yes
No
Would have to check
Would your therapist want to be inlcuded to speak about your mental health journey
*
Required
Yes
No
Would have to confirm.
Briefly describe why you wanted to be apart of The Fade Project
Are there any special considerations or needs that we should no prior to filming.
We will need to also have a supporter of your mental health journey apart of the project. Do you know who you will have and thier relationship with you?
If there’s one story from your life you’d like others to hear, who would it be and there significance?
Please upload a headshot of yourself.
Upload Here
Upload jpeg/png file (Max 15MB)
By checking this box, you you consent to the use of your image, likeness, and story in promotional materials related to the film. You give permission for your interview to be recorded?
Choose a date
Choose a time
11:00 AM
12:30 PM
02:00 PM
SUMBIT
Thanks for applying! We’ll get back to you soon.
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