APPLICATION FOR AUTHORIZATION
PROFESSIONAL THEATER COMPANIES
1.- Play title (For foreign plays, please quote both the original title and the title under which it will be performed in Chile):
2.- Full name of the original author:
3.- Name and address of the applicant:
4.- Name of the company:
5.- Name of the company director:
6.- Performance language:
7.- In case of using an existing translation and/or adaptation, please give the name of the translator and/or adapter:
8.- If the play is intended to be translated and/or adapted, please give the name of the person who will translate and/or adapt it:
9.- Approximate number of performances:
10.- Approximate admission fee:
11.- Name of the hall where the play will be performed and seats number:
12.- Anticipated date of premiere:
13.- Term for which the authorization is requested:
14.- Covered territory:
15.- Is exclusive authorization requested Yes Not
16.- Approximate total budget of the production: US$
Date: Rut.:

Signature:

 

 
NOTES:
1. When the Request of Authorization is for representation of a work by an ATN's non member author, the request must pay, by the time of submitting such request the amount of 1UF in respect of management expenses,wathever it is the result of it.
2. The application must be accompanied with the résumés both of the director and the company, and those ones of the translator and/or adapter in case of translation and/or adaptation.
Send fax: (56-2) 370 8070