Please leave this field empty. Company/Applicant Name (responsible for the filming)
Does the company name match the name insured on the public liability insurance (PLI)? Please note: A permit will not be issued without current PLIYesNo
Please provide more information
Name
Position/Title
Phone
Email
Project Name
Production TypeFeature FilmTV One-Off or SeriesShort FilmStudent FilmTVCOther
Please specify:
Please specify name of program:
How will this project be distributed? (e.g. online, television, cinematic release)
Proposed Filming Dates FromTo
Alternate Filming Dates FromTo
Filming Times (including bump-in and bump-out times)
Exact location/s of the proposed filming
Please provide a brief summary or synopsis of the scene and/or activities and why you have chosen NGV as the location to film this
Number of cast on location
Number of crew on location
Will the production need a unit base?YesNo
Please add your unit base to your site plan/mud map to the attachments at the end of this document
Exact location/s of the proposed unit base? (Including any privately owned land.)
Unit base times (start/finish)
Will the production erect any temporary structures such as tents or marquees at the unit base?YesNo
Please provide details of these temporary structures (size, number, style) Please note: temporary structures need to be secured by weights, not pegs or stakes.
Will the production require traffic management or pedestrian management? Please note: If the production is disrupting traffic or pedestrian flow a Traffic Management Plan (TMP) or Pedestrian Management Plan (PMP) Incorporating a Risk Management Plan will be required.YesNo
Type of activity (e.g. hold & release, road closure)
Name and details of the traffic/safety company who will be supplying the TMP or PMP?
What times will the roads be affected? Start of closure Finish of closure
Name of the roads affected by the closure/traffic hold?
Details of any large equipment the production will bring to the location (e.g. camera cranes, scaffolding, lighting towers)
Please indicate if the production will involve any of the following. *Confirmation of approval from Victoria Police or other state government agencies will be required with this application.firearms/weapons (including imitation)*other safety concerns*may have environmental impactamplified music or soundstunts*may cause offense or concern to the public
Provide details of activity
Will the proposed filming represent the actual location? YesNo
Please identify the location the filming will represent
Please include the relevant documentation for your production. If the documentation is unavailable to be sent at this time please indicate via email the date on which it will be sent.
Public liability insurance Proof of certificate of currency ($10 - $20M cover)
If you’re unsure which of the following documentation you need to attach, contact us to discuss.
Site plan/mud maps Identifies Parking, Traffic control, unit base, where crew are situated and any equipment other than the normal amount of filming equipment required for the shoot e.g cranes, long dolly, boom lifts, scissor lifts.
Running Sheet/Schedule A document which establishes a chronology, linking times, events and details of filming activities.
Stakeholder communication plan (Public notification letter) The purpose of this is to give traders, residents and other interested parties timely written notice in advance of your proposed filming activities and show how you’ll address their concerns.
Traffic & Pedestrian management plan(s) Required if traffic will be slowed, blocked, redirected, or perhaps even distracted. Be certain to check if you need permits from Victoria Police and VicRoads (attach your copies of their permits in the ‘Other permits, approvals etc’ section at the end of this form).
Risk management plan or safety plan Complete this if a risk management plan isn’t already attached to a traffic management or pedestrian management plan, or other activities involve risk you need to manage, e.g. trip hazards, explosives.
Other permits, approvals or filming information (running sheets, schedules) Any other permits or approvals we have asked you for. For example Victoria Police, VicRoads, Parks Victoria, a waste management plan, etc.
We agree to abide by the Victorian Screen Industry Code of Conduct (mandatory).
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