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Set Construction
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.

PROVIDE DETAILED DESCRIPTION OF THE SET CONSTRUCTION

Where will this set be located?

Dimensions of Set?:

Type of Materials used?:

Who will Construct the Set?:

Is the Set Free Standing?: Yes No

How will the Set be anchored?:

Scene description used within this Set?:

Will Scene include Hazardous Activities?: Yes No
If Yes, be sure to complete required Hazardous Shoot forms.

Will construction include Electric?: Yes No

Will construction include Water?: Yes No

If Yes to either Electric or Water, who will be installing the Utilities?

Does the Set have movable parts?: Yes No

If Yes, explain in detail?

Email all associated floor plans and/or drawings of the Set to:
insurance.student.film@nyu.edu


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