Request edit access
Right To Harm Screening License Purchase Form
Community screenings will begin August 1st. Please complete this form to purchase a community screening license for RIGHT TO HARM.

After you have completed the form an invoice will be emailed to the email address provided. Once the invoice is paid a DVD or bluray will be shipped to your preferred mailing address.

Your screening purchase includes:
- The full feature film
- A shortened version of film
- A comprehensive discussion guide and screening toolkit

A $10 shipping charge will apply to all orders. An additional 3% will be added to all credit card processing.

Host or Sponsor Organization *
Your answer
Full Name of Primary Contact *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Mailing Address, City, State, Zip Code *
Your answer
Billing Contact & Email Address *
Your answer
Screening Venue *
Your answer
Venue Address *
Your answer
Screening Date (if you are requesting multiple screenings, list the first date) *
Time of Screening *
What type of screening license would you like to purchase? *
How would you like to pay? *
Would you like a blu-ray or DVD? *
Additional Requests
Questions or comments:
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service