Request Footage (All footage requests must be received 30 days prior to the deadline date.)
Client Information
Client/Company:
Type of Company:
Contact Name:
Title of Individual:
Street Address:
Address (Cont.):
City:
State/Province:
Zip/Postal Code:
Country:
 US Other:
Phone:
Fax:
E-Mail:
Website:
Footage Information
Detailed Description of footage:
Sole Purpose for Footage:
Tape Requirements:
Format:
 VHS      Qty:
DVD      Qty:
Beta SP      Qty:
DVCpro      Qty:
(at additional cost)
DVCpro HD      Qty:
(at additional cost)
Quote Deadline:
Royalties
Specify Territory For Use:

United States

Canada
North America
Worldwide
Other
 
Medium:
(Choose all that apply)
Commercial
Broadcast TV
Corporate Video
Educational
Home Video/DVD
Music Video
Video Game
Trade Show
In-Store Promotion
Theatrical / Feature Film
Non-Profit Event(non-broadcast)
Internet
Media
Other
License Term:

1 Year
2-10 Years
In Perpetuity
Additional Comments

Additional Comments: