Name *

First Name

Last Name

Phone

(###)

###

####

Company Address

If Applicable

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What type of event are you planning?

(Please check all that apply)

Ticketed

Free for attendees

Fundraiser

Donation-based

Still figuring that out

How will this screening take place?

Note: All virtual screenings must use our secure screening platform.

In-person

Virtual (hosted on our platform)

Hybrid (some attendees in-person, some virtual)

Audience Access

Note: Private screenings should not be promoted on public social media. Internal emails or newsletters are welcome.

Private (e.g., limited to members of your group or conference attendees)

Open to the public

Will this screening include a Q&A or post-film discussion?

Yes

No

Would you like to invite Maggie & Jeremy (the filmmakers) to speak at your event?

Yes, in person

Yes, virtually

No

Name *

First Name

Last Name

Phone

(###)

###

####

Venue Address (Street, City, Country)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Proposed Screening Date

MM

DD

YYYY

Have you hosted a film screening at this venue before?

Yes

No