Talentville Industry Application

Personal and Company Information

Note: Your email address, street address and phone numbers will never be shared with site members.

First Name: Last Name:

Email: Phone #:

Company: Company Website:

Address:

City: State/Province: Postal Code:

Country:

Professional Information

Title: (check all that apply)

Agent - Literary

Producer - Creative

Agent - Talent

Producer - Line

Manager

Production Executive

Director

Produced Writer

Other:

iMDb Listing:

Other Professional Listing:

Talentville Account Information

Email Address:
Password: (6-20 alphanumeric characters)
Re-enter Password: