Questionnaire

Ready to host a movie screening?

Alright, lets get started!

* Indicates required field

ORGANIZATION OR SCHOOL NAME *

Anticipated Date & Time *

Corespondent Name *

PHONE *

EMAIL *

WHO TO MAKE THE SCREENING LICENSE OUT TO: *

The organization or person hosting the event

Who to make the Invoice out to *

SHIPPING ADDRESS *

TYPE OF PROJECTION *

DVD (For Standard Definition TV Displays) BLU-RAY (For High Definition Displays and Projectors)

Expected Audience Size (approx) *

10-25 25-50 75-150 150-300 300+

SCREENING TYPE *

Film Festival Government Screening School / University Non-Profit or Advocacy Organization Other

Interested in having a survivor leader or filmmaker come speak at your next event alongside the film? *

Yes No Maybe

HOW DID YOU HEAR ABOUT US? *

ORGANIZATION WEBSITE *

SOCIAL MEDIA TAG *

Please share any additional information we need to know about this request *

Submit