Screening Request
Please fill out the form below to request screening license and materials.
Name(s) of Requested Film(s) (required)
One or more film names is required.
Your Name (required)
Your full name is required.
Your Phone Number (required)
A valid phone number is required.
Your Email Address (required)
A valid email address is required.
Organization Name (required)
Organization name is required.
Organization Address Line 1 (required)
Address line 1 is required.
Organization Address Line 2
Organization City (required)
City is required.
Organization State/Province (required)
State/Province is required.
Organization ZIP/Postal Code (required)
ZIP/Postal Code is required.
Organization Country (required)
Country is required.
Organization Website
Organization Social Media Handles (required)
Select business type...
For profit
Nonprofit
Business Type (required)
The type of business of your organization is required.
Select organization type...
Cinema
Education
Film festival
Museum
Other
Organization Type (required)
The type of organization is required.
Additional Organization Notes
Venue Name (required)
Venue name is required.
Venue Address Line 1 (required)
Address line 1 is required.
Venue Address Line 2
Venue City (required)
City is required.
Venue State/Province (required)
State/Province is required.
Venue ZIP/Postal Code (required)
ZIP/Postal Code is required.
Venue Country (required)
Country is required.
Venue Capacity/Number of Seats (required)
The approximate venue capacity/number of seats is required.
Number of Screenings Requested
The number of screenings is required.
Screening Date (required)
A proposed screening date is required.
Screening Time (required)
A proposed screening time (ex. 7:00pm, 8:30pm) is required.
Screening Date Details
Is Your Event Ticketed?
What is the Ticket Price?
A value of $0.00 (free) or more is required.
What is the Expected Attendance? (required)
An estimate of expected attendance is required.
What is your Marketing Strategy/Plan?
Select screening format...
SELF SUPPLIED
DCP
MP4
Screening Format (required)
Your preferred screening file format is required.
Any Equipment Setup and Needs?
Add Your Additional Comments/Notes
Agreed upon screening fee (if applicable)
If fee already determined, provide a USD value or N/A.
Select payment method...
CHECK
CREDIT CARD
ACH
Payment Method (required)
Your method of payment is required.
Billing Name (required)
Billing name is required.
Billing Address Line 1 (required)
Address line 1 is required.
Billing Address Line 2
Billing City (required)
City is required.
Billing State/Province (required)
State/Province is required.
Billing ZIP/Postal Code (required)
ZIP/Postal Code is required.
Billing Country (required)
Country is required.
Billing Phone (required)
Billing telephone number is required.
Billing Email (required)
Billing email address is required.
Fedex Shipping Code
I agree to the
MPI Media Standard Terms and Conditions
You must agree to the terms and conditions to proceed.
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Submit Screening Request
Please review the form above. Some required fields need your attention.
