OID - Video Submission

OID - Video Submission
First Name *
Last Name *
Email *
example@example.com
Phone Number *
Please enter a valid phone number.
File Upload *

Cancel of
Title of your Video *
Info about your video *
Where was Video Taken *
Date Video was Taken *

Month Day Year
Date
Did you record this video? *

YES NO
Do you own this video? *

YES NO
Are you over 18 years of age? *

YES NO
Have you already submitted your video or granted rights to any other company? *

YES NO
To who have you submitted or given rights to this video?
Signature *

Clear
Should be Empty: