Speaker Request Form
Please share as much information as possible to help us serve your needs
Community or Faith Organization
Tribal Government or Tribal Organization
Is this speaker invited via video or in-person? (choose the most likely scenario)
Via Video (Zoom, Skype etc.)
Which film(s) would you like to screen (check all that apply)
Have you completed your purchase or booking of the film?
I Don't Know
Have you or your organization organized a successful film screening previously?
Do you know which speaker(s) you would like to join you? (You may check multiple people)
Adam Mazo (co-director, co-producer)
Mishy Lesser (learning director)
Tracy Rector (impact producer)
Esther Anne (Maine-Wabanaki REACH)
Chris Newell (senior adviser)
Dawn Neptune Adams (film participant)
I don't know, please send me more information.
Ideal Date for speaker to attend your screening (present - 2022)
~if unsure, provide your best estimate~
Any additional info about ideal date?
Estimated Audience Size
Less than 30
Are you working with any partner organizations you would like to mention? (please list names)
Anything else you want us to know about your screening plans?
Send me a copy of my responses.
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