Historical Trauma Film Screening Request

First Name (required)

Last Name (required)

Organization (required)

Your Email (required)

Street Address (required)

Suite

City (required)

State/Province (required)
—Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming--District of ColumbiaPuerto RicoGuamAmerican SamoaU.S. Virgin IslandsNorthern Mariana Islands--AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewan

Country

ZIP (Postal) Code (required)

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How many people will view the film?

Who is the screening for? (educational, civics, governmental, etc.)

Requested Date of Screening?

Would your audience participate in a post screening survey?

Would you like to have a speaker from the film at your screening? (additional cost will apply)

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Please Select Your Licensing Request—Information on PPR and DSL licensing is located at the bottom of this page

PPR Options

Higher Edu./Middle & High school screenings with Public Performance Rights (PPR): $295Corporation screenings with Public Performance Rights (PPR): $395Native community screenings with Public Performance Rights (PPR): $195.00PPR not needed

DSL Options

Digital Site License (DSL) with PPR, starting at: $395BluRay DVD + DSL bundle with PPR starting at: $4959-12's School, Non-profit with PPR: $175For Native Youth screenings (age appropriateness should be reviewed by community leaders), we only charge for shipping, if needed.DSL not needed

Media Requested (choose one)

BluRay DVDStandard DVDStreaming linkDCP (for theaters)

Payment Method (required) If paying by CC, we will email you an invoice to pay online.
—Please choose an option—Purchase OrderOnlineCheck

Email address where we should send an invoice (required)

Depending upon your payment method, we will be sending you an electronic invoice that can be paid online with a credit card or we will invoice you.