2023 SCREENING APPLICATION

2023 Screening Application

Hosting Organization

Event Coordinator

First NameLast Name

Cell Number

Area CodePhone Number

E-mail

Shipping Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Organization Website

Organization Social Handles

Facebook, Instagram

Live Event Location

Venue Name, Address, City & State/Province

Live Event Date & Time

(TBA if undecided)

Virtual Event Location & Date

City, State/Province

List Any Venue Age Restrictions

Ticket Prices

Advance & Door Prices (TBA if undecided)

Locations where physical tickets can be purchased

Screening License Fee

Please process my deposit now!$250.00

I prefer to pay the full license fee now!$600.00

Payment by check/chequeFree

Please mail your full payment ($900) or deposit ($250), payable to International Fly Fishing Film Festival (111, 7 Avenue S, Suite A Cranbrook, BC V1C 2J3)

Add a sponsor swag pack$200.00

Fly Fishing gear and swag from our sponsors to give away or raffle at your event! Pack valued at over $400!

Total $0.00

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Signature

By signing above, I acknowledge that I have the right to act on behalf of the hosting organization listed above.

Screening License Fee*

Screening License Fee