Submission Form
PIC welcomes documentaries of unique and untold stories of the Pacific Islander experience. Pacific Islanders are defined as the descendants of the indigenous peoples of Hawai`i, Guam, American Samoa, the Northern Marianas, and other Pacific Islands of Micronesia, Melanesia, and Polynesia.

We are currently seeking films in the fine cut stage or completed films to broadcast during the 2019 season.

Email address *
Film Title *
Your answer
Length *
Your answer
Film Format *
Which format was your film finished in?
Film Synopsis *
800 character limit
Your answer
Producer Information
Producer First Name *
Your answer
Producer Last Name *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Country *
Your answer
Distribution Information
1. U.S. Television Broadcast Rights *
Are the exclusive U.S. Television Broadcast Rights available for 4 years?
2. U.S. Distribution *
Has your film been or is currently being distributed in the U.S.?
3. U.S. Distribution Details
If you answered "Yes" to question #2, please list how your film has been distributed (e.g. festivals, home video, etc.)
Your answer
4. International Distribution
If your film has been distributed outside the U.S., please provide details below.
Your answer
Rights Clearance
1. Acquired Material *
Does your film contain acquired material (e.g. music, acquired footage or visual arts)
2. Acquired Materials Clearances
If you answered "Yes" to question #1, for what uses are the materials cleared? Check all that apply.
3. Acquired Materials Not Cleared
If the acquired material in your film is not cleared for any of the uses in question #2, please specify what material isnʻt cleared.
Your answer
4. Who is the copyright holder of the film? *
Your answer
5. Do you have E&O insurance? *
Funder Information
1. Funders of the Film *
Please list all the funders of your film with the amounts they provided.
Your answer
2. Funder Connection to the Film
Do any of your funders have a connection to the making of your film (e.g. appearance in the film, viewing cuts, etc.)
Adult Content
1. Adult Content *
Does your film contain any of the following, please select all that applies.
2. Adult Content Details
If you selected any of the above (except for "None") please provide timecode for each instance and description of the adult content.
Your answer
Film Submission
1. Link to the Film *
PIC is unable to accept DVD submissions. Please provide a link to a third party video sharing or file transfer website (e.g. Vimeo, Dropbox, etc.). Your film must be no more than 1 GB in size, downloadable and password protected.
Your answer
2. Password *
Your answer
Certification *
By affixing your name below you certify that all the information you have provided in this form is true and that you have the authority to submit this film for Pacific Heartbeat consideration.
Your answer
Todayʻs Date *
How did you hear about Pacific Heartbeat? *
Would you like to subscribe to PIC's monthly newsletter
Stay up to date with the latest news and events
Never submit passwords through Google Forms.
This form was created inside of Pacific Islanders in Communications. Report Abuse - Terms of Service