If your Browser blocks Active Content, Please click on the Information Bar above & Allow Blocked Content!
RailRoad Exposures
Students: Read and Complete This Entire Form
GENERAL INSTRUCTIONS:
Use the TAB key or MOUSE click to move from field to field.
CAUTION: Using the ENTER key will automatically submit the form.

PLEASE REVIEW YOUR SUBMISSION BEFORE CLICKING "SUBMIT"
Distribution of Certificates
This is a SPECIAL INSURANCE REQUEST, it may take an additional one to two weeks to process your insurance, so start early.
PLAN ACCORDINGLY!!
GENERAL PRODUCTION INFORMATION

Have you submitted the "Production Registration Form"?:
Yes  No

If you answered "No" this will redirect you to the proper Production Registration Form.

Original Name of Production:

Director's Name (No nicknames. List name as registered with NYU!):
First Name:
Last Name:
Insurance Contact - Email Address:
Email address must be an NYU issued email.
Must end in @nyu.edu. All others will be rejected, and your form will have to be resubmitted.

First, you will have to fax (212-995-3555) or drop off (838 Broadway, 4th Floor)
a copy of the Railroad's Contractual Agreement. Make sure your Name, and the
Production Name, are on a cover sheet attached to this document!

Railroad Contact Name :

Railroad Contact Phone Number :

Description of scenes involving railroad equipment:


Dates and times equipment is to be used:


Location of Equipment:

Where is Equipment being stored?

Where is Equipment being moved to? Exact street address:

Where is Equipment being returned to after use is completed?

Type of Equipment used? (Rolling cars, engines or other equipment)
Please provide a detailed list:


Describe activities involving the railroad equipment and personnel:


How many people will be "on board"?

Distances and speed of equipment"?

Any Stunts? Yes No
If Yes, please list:


Will Main Line tracks be used during filming days? Yes No
If Yes, please describe:


What security measures are being taken to keep public away from the railroad cars?


Will there be an interruption of regular service? Yes No
Please explain either Yes or No answer:


Will the train be:
under the direction of the production company
or will it maintain it's normal routes, speeds, schedule, etc.?
Is the Train being brought from another location to the filming location?:
Yes No
Provide full details of how the Railroad Equipment will be transported.
Include the addresses of the locations and the distances.


Who is responsible for the Equipment while in transit?


If you want a copy of this form for your records, print it before hitting the Submit button!


If you don't see a PRINT button above, use your browser to print this form for your records.
Use the Landscape setting on your printer to get the best results.