"The Age of Love" Community and Classroom Screening Application
Thank you for applying to host a screening of 'The Age of Love'. We're excited to be partnering with you! Please fill out the information below so that we can prepare materials to help you plan your event.
Sign in to Google to save your progress. Learn more
Basic Screening Information
Date of Screening *
MM
/
DD
/
YYYY
Time Screening Begins *
Time
:
Host Organization Information
Your Organization *
Partner Organizations (if any)
First Name *
of the individual responsible for coordinating this event
Last Name *
of the individual responsible for coordinating this event
Title *
of the individual responsible for coordinating this event (e.g., Program Director)
Coordinator's Phone Number *
Coordinator's Email Address *
Organization's Website
if applicable
Address (Line 1) *
of organization
Address (Line 2)
of organization
City *
of organization
State *
of organization
Zip Code *
of organization
Country *
of organization
Detailed Event Information
Anticipated Audience Size *
Number of Screeings *
If you are interested in hosting multiple screenings of the film, please indicate that below.
Venue Name *
Theater or specific room where the film will be shown
Venue Address
Please specify if different from Organization Address
Public or Private Event *
Is this event going to be advertised to the general public?
If public, please note if RSVP is required and the RSVP phone number/email.
Is there a charge to attend? *
Please write either FREE or TICKETED (plus ticket price)
Ticket Price
How much do you plan to charge for this event?
URL of your web page which contains detailed screening info, if any.
Other elements planned around your screening?
Q&A, panel discussion, supper, dessert, etc.
Speed Dating Event *
Are you interested in learning more about hosting your own Senior Speed Dating Event?
Proposed Speed Dating Event Date
We recommend using the screening to announce the event, which is scheduled 3 - 4 weeks later.
MM
/
DD
/
YYYY
Shipping Information
Shipping Name and Address for Film and Screening Kit
Please specify if different from Organization Address. Note: a Classroom Screening is delivered via streaming link, so no Shipping Address is needed.
Format *
A Blu-ray provides a Hi-Definition picture and additional sound options, but requires a Blu-ray player. PLEASE MAKE SURE to provide us with the correct selection, as movie theaters often request a Blu-ray (though a DVD will work fine in all venues). If you're not sure right now, please leave a comment below, then let us know as soon as you can.
Comments (and any Promo Code)
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms