NIS America, Inc. - Anime Screening Consent Form
Thank you for requesting permission to show our anime programs (“Programs”) at your meeting, event, or convention. We appreciate your effort to enhance public interest in Japanese culture. We are happy to give you permission to screen our Programs (See Title List), PROVIDED THAT you and your organization comply with the following conditions:

1. No charge, whether direct or indirect, shall be made for the purpose of viewing the Programs;
2. No copying or replication of the Programs will be conducted during the screening, or at any other time;
3. Screened Programs shall be original commercial copies, and not duplicates;
4. No photo, video, or audio recording is permitted during the viewing session;
5. The Programs and associated content shall be shown in their entirety, including trailers;

All other rights are expressly reserved.

This consent form MUST be submitted BEFORE your planned event. Keep in mind that this approval applies only to the specific screenings listed.

*
Required
TITLE LIST
Please select the Blu-ray and/or DVD title(s) you'd like to screen, but don't get crazy. Please limit the number of requested titles to at most 8 titles.
Blu-ray Titles
Please select the Blu-ray title(s) you'd like to screen. *
Required
DVD Titles
Please select the DVD title(s) you would like to screen. *
Required
Do you have the screeners on-hand? *
If you have some, but not all of the requested screeners, please list the screeners you'll need under "Other".
EVENT INFORMATION
Event name *
Your answer
Street address 1 *
Your answer
Street address 2
Your answer
City *
Your answer
State/Province/Region *
Your answer
ZIP *
Your answer
Country *
Your answer
Start date *
MM
/
DD
/
YYYY
End date
MM
/
DD
/
YYYY
Event Website:
Your answer
Anticipated attendance # *
Your answer
Previous attendance #
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of NIS America, Inc.. Report Abuse - Terms of Service - Additional Terms