From the Ashes Screening Registration Form
Go beyond the rhetoric of the “war on coal” in From the Ashes, and experience the compelling and often heartbreaking stories about what’s at stake for our economy, health, and climate.

By hosting a screening of this film at your business, school, club, or non-profit, you can invite your community to learn more about an industry on the edge and what it means for their lives.

In this 80 minute documentary, From the Ashes captures Americans in communities across the country as they wrestle with the legacy of the coal industry and what its future should be under the Trump Administration. Learn more at www.fromtheashesfilm.com.

First Name *
Your answer
Last Name *
Your answer
Email address *
Your answer
Phone Number
Your answer
Name of your school, organization, non-profit, or affiliation. *
Your answer
Are you a member of the Sierra Student Coalition? *
Where do you plan to host your screening? *
This could be your school name, the address of your office, or the specific theater on campus. Host a house party! Please include the street address.
Your answer
What date do you plan to host your screening? *
You don't have to be exact, but a sense of timing helps us support your screening.
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What time do you plan to host your screening? *
Time
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How many people will attend your screening? *
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Who are the potential attendees ? Check all that apply *
Required
How did you hear about FROM THE ASHES? *
Shipping address
Once you fill out this form, and we review the information, we will ship your DVD and education guide to this address. PLEASE NOTE, WE CANNOT SHIP TO PO BOXES
Street address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Please confirm that you agree to the following
Every screening host must commit to the following criteria in order to receive their free DVD of From the Ashes.
I agree that: Yes, I agree to all terms *
Required
Next steps:
As soon as you register to host a screening, we will send you the following materials. The event is then yours to plan!

1. After you complete this form, we will send you a confirmation email to lock in your screening date/time/venue.

2. After your confirmation, we will send you a guide to help you host your screening, social media kit, and graphics.

3. We will mail a DVD copy of the film to the mailing address you provide. Packaged along with the DVD you will receive a small poster and promotional postcards.

3. After the screening, please send pictures and complete the follow-up survey.

Any additional notes or questions?
Your answer
By submitting my information, I agree Picture Motion can share my information with Bloomberg Philanthropies and I agree to Bloomberg Philanthropies' privacy policy: https://www.bloomberg.org/privacy/. I also hereby authorize Bloomberg L.P. and its affiliates ("Bloomberg") to use my name and photograph for promotional purposes in print and via internet, or in any other medium, as deemed fit by Bloomberg throughout the world. I release Bloomberg from any and all claims based use of my name, likeness or image.
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