Application: Translation and publishing of an illustrated publication

Application form

1. Information about the applicant

1.1. Applicant^*

(name of the legal person, company code)

1.2. Representative (authorised signatory)^*

(name, and position)

1.3. Contact person^*

(for queries relating to the information provided in the application)

1.4. Country of registration^*

1.5. Website

1.6. E-mail^*

1.7. Phone number^*

1.8. Applicant’s profile^*

(max 1500 characters)

1.9. List of translations published by the applicant in the last two years^*

2. Information about the publication

2.1. Author/s^*

2.2. Title in Lithuanian (or title in original language)^*

2.3. Year of publication in Lithuania and publisher^*

(if applicable)

2.4. Target audience^*

2.5. Language into which the publication is to be translated^*

2.6. Preliminary title in target language^*

2.7. The work is to be translated from the original language^*

YesNo

2.8. If the work is not to be translated from Lithuanian but from another (intermediary) language, please indicate the reasons and the language

2.9. Planned format of the publication^*

PaperElectronicAudio

2.10. Planned distribution channels of the publication and partners^*

(max 1500 characters)

2.11. Planned marketing activities^*

(max 1500 characters)

2.12. Estimated publication date^*

(month and year)

2.13. Estimated print run^*

(no less than 500 copies, for poetry or drama publications no less than 300)

2.14. Brief justification of the need for the project (why translation of the publication is relevant)^*

3. Information about the translator

3.1. Name^*

3.2. E-mail^*

3.3. Link to free publicly available information on the translator’s professional activities and a list of translated works

(if available)

3.4. Brief justification of the translator's motivation for translating the publication^*

4. Detailed estimate of project costs and deadlines for activities

Project implementation activities	Completion of activities (year, month)	Projected costs, EURO
Translation
Editing, proofreading
Design, layout
Printing
Distribution and Marketing
Other activities (please specify):


Total of projected costs, EURO

5. Information on the costs requested for funding

Project implementation activity	Amount requested from LCI, EURO
Translation
Publication (up to 1000 EURO)
Total, EURO

Please specify the publishing activities for which funding is requested:

Publishing activity	Amount requested from LCI, EURO
Acquiring copyrights
Editing, proofreading
Design, layout
Printing

Price per page, line, EURO (if applicable)^*

(per page - 1800 characters with spaces)

Please attach:

1. A copy of the contract or other written agreement between the applicant and the copyright holder of the publication referred to in the application, granting the applicant the right to use the publication to the extent specified in the application.^*

* possible attachment formats: jpg, png, pdf, doc, docx, xls, xlsx