Host a Screening of "LOOK AT US NOW, MOTHER!"
Please complete the form below and we will follow up with you as soon as possible.
NOTE: All public screenings **require** a license, the cost of which will be determined based on your responses below.
Sign in to Google
to save your progress.
Learn more
* Required
Email
*
Your email
Name
*
Your answer
Email
*
Your answer
Phone
*
Your answer
Organization / Affiliation / School Name
Your answer
City
*
Your answer
State / Province
*
Your answer
Country
*
Your answer
Desired Date of Screening
MM
/
DD
/
YYYY
Venue Size / Number of seats (we cannot supply a screening quote without the venue size)
*
Your answer
Are you charging for tickets?
*
Yes
No
Is the screening open to the public?
*
Yes
No
Is this a fundraiser?
*
Yes
No
Would you like to invite the filmmaker to the event?
We would love to invite Gayle; please send details!
No, thanks
Clear selection
What kind of media will you require to screen LOOK AT US NOW, MOTHER! ?
BluRay
DVD
DCP (Digital Cinema Package)
Clear selection
Do you plan to advertise the event? If so, how?
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This form was created inside of Kirschenbaum Productions, Inc..
Report Abuse
Forms
