Microplastic Madness - movie screening request form
In emergencies please contact us at info@cafeteriaculture.org
Email address *
How did you hear about our film? *
Your answer
Host organization contact information
Organization name *
Your answer
Organization description *
Your answer
Type of organization *
If you are an "Educational - Public K-12" organization, are you a Title 1 school? *
Organization website *
Your answer
Social Media handles *
Your answer
Name of key contact person *
Your answer
Email address of key contact person *
Your answer
Phone number *
Your answer
Please share information about your screening/event
What is your preferred time frame/event date(s) for screening? *
Your answer
How many screenings will you hold? *
Your answer
Name of event *
Your answer
Type of event *
Venue Name and Address *
Your answer
Venue Type *
Seating Capacity *
Your answer
Audience (Check all the apply) *
Required
In what format will the film be shown in? *
Are you charging admission? *
If you are charging admission or suggested donation, what is the price for a ticket? (If free, enter "N/A") *
Your answer
Do you plan on hosting a separate screening at a Title 1 school? (If so, the screening fee will be waived) *
Questions on Post-Screening Panel
Are you planning a post-screening panel or Q&A? *
If so, are you interested in someone from Cafeteria Culture joining the panel? (please note that we have limited resources for this right now but are taking requests)
Your answer
Almost done!
Please share additional details here
Your answer
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