REIMBURSEMENT AND RECOMMENDATION FORM Respondent - Recommendation Form Respondent Information Respondent First Name Respondent Last Name Respondent's Institution Respondent's Address Respondent's Address Street Address Street Address Apt, Suite, etc. Apt, Suite, etc. City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Respondent's Office Phone Respondent's Home Phone Respondent's Email Valid Email Confirm Respondent's Email Confirm Email Personal Car Miles x $0.33/mile = Car Reimbursement $ AND/OR Other authorized transportation (train, plane, tolls) + Other Reimbursement $ Production Details Production Title * Producing Institution * Opening Night * Use the following format - dd/mm/yyyy. Date Seen * Use the following format - dd/mm/yyyy. Production State Choose One... IllinoisIndianaMichiganOhioWisconsin KCACTF Sponsorship Billing In Program? * Choose One... YesNo Running Time, Including Intermission * House Capacity Director's Name * Student Director? Choose One... YesNo Director's Email Dramaturg's Name Student Dramaturg? Choose One... YesNo Is this a musical? Choose One... YesNo School Representative Email Note: The email of the person at the institution who should receive this report. Probably the director, but may be the department chair or other person. If you are not sure, ask the school. Particpating or Associate? Choose One... Associate ProductionParticipating Production Did the host college arrange for a post-show talk, according to KCACTF standard practice, and was sufficient time for the response provided, with most of the company in attendance? Choose One... YesNo If no, please explain what was not included and why, as well as any alternate response feedback planned (including emails, followup, phone calls, etc.) Check all categories that apply: Original Play Student-Written Student Costume Design Student Scenic Design Student Lighting Design Student Makeup Design Student Sound Design Scenic Designer Costume Designer Lighting Designer Sound Designer Technical Director Props Designer/Coordinator Stage Manager Other Key Personnel Nominations and Recommendations Irene Ryan Acting Scholarship Nominations: The director may nominate only one (1) candidate, and that nomination must be made at the time of the KCACTF response. FOR ASSOCIATE PRODUCTIONS, ONLY ONE (1) additional nomination MAY be made by the respondent. For PARTICIPATING PRODUCTIONS, two (2) additional nominations MAY be made, one by each respondent. Ryan decisions should be made before the respondent(s) leave campus. Include all names on this form. All candidates must be bona fide college students (as defined on the Kennedy Center website, http://www.kennedy-center.org/education/actf/) at the time the show is seen by the respondents. Faculty members in the department must be able to verify their bona fide student standing. Ryan Nominee 1 Ryan Nominee 2 For participating productions only: Ryan Nominee 3 For associate entries only: recommended for Celebration of Associate Productions. (required) Choose One... YesNo For entries: recommended for Festival Costume Parade? (required) Choose One... YesNo If so, which costume(s)? For all entries with student director: recommended for Ten-Minute Play Festival? Choose One... YesNo Certificate of Merit Nomination Throughout each festival season, respondents to both associate and participating productions have the opportunity to honor truly exceptional production contributions worthy of special recognition by awarding Certificates of Merit to individual artists, and/or ensembles (both student and faculty). All production elements are eligible for consideration, including: design, stage management, technology, performance, directing, dramaturgy, etc. Respondents will identify Certificate of Merit awardees in the production response form submitted to the regional chair after seeing a production. Certificates of Merit will be made available to the producing schools at the Regional Festival registration desk. Individuals and / or elements nominated (e.g., Susan Jones, lighting design): Notes of explanation for Celebration of Associate Production, Festival Costume Parade Recommendation, and/or any Certificates of Merit: Dropdown Option 1 If you are human, leave this field blank. Submit Δ
