JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Educational Film Order Form
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name
*
Your answer
Professional Title
*
Your answer
Department
*
Your answer
Institution
*
Your answer
Address 1
*
Your answer
Address 2
Your answer
City
*
Your answer
State/Province
*
Your answer
Zip Code
*
Your answer
Country
*
Your answer
Billing Address
If different from above.
Your answer
Telephone
*
Your answer
E-mail
*
Your answer
Focus on Chile' Package of 3 Films - Get 40% off (Regular $1196) Sale: $716!
Includes 3 films: "The Chilean Building," "El Huaso: The Last Rodeo" and "The Naked Room"
Focus on Chile' Package of 2 Films - Get 30% off (Regular $796) Sale: $448!
Check the two films you are purchasing
"The Chilean Building"
"El Huaso: The Last Rodeo"
"The Naked Room"
Film Title
"The Chilean Building" - $298
"El Huaso: The Last Rodeo" - $298
"The Lips" - $298
"The Naked Room - $298
"Porfirio" - $298
"Price of Gold" - $298
"Thursday Till Sunday" - $298
"Xu Bing: Phoenix" - $178
"A Dress Rehearsal for an Execution" - $248
Clear selection
Quantity
*
Your answer
Promotion Code
Your answer
Payment
*
Credit card payment coming soon!
Check
Money Order
Wire Transfer
How did you hear about this film?
*
Postcard
Website
Newspaper Article
Festival Screening
Colleague
Friend
Other:
Which subjects you are interested in purchasing films about in the next year?
Your answer
Notes
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
Forms
This content is neither created nor endorsed by Google.
Report Abuse
Terms of Service
Privacy Policy
Help and feedback
Contact form owner
Help Forms improve
Report