You can always press Enter⏎ to continue
White Rock
Community Screening Request Form
12
Questions
START
1
Name
Previous
Next
Submit
Press
Enter
2
Email Address
example@example.com
Previous
Next
Submit
Press
Enter
3
Phone Number
Previous
Next
Submit
Press
Enter
4
Location of Screening
Town/Suburb, State/Territory, and venue name if known.
Previous
Next
Submit
Press
Enter
5
Organisation Affiliation
If appropriate
Previous
Next
Submit
Press
Enter
6
Ideal Date(s) for the Screening
Let us know if you’re flexible or have a specific timeframe in mind.
Previous
Next
Submit
Press
Enter
7
Type of Screening
Tick boxes and/or add your own
Community event
School or university screening
Council-led initiative
Film festival or environmental event
Other
Previous
Next
Submit
Press
Enter
8
Why are you interested in hosting a screening?
A short answer about your motivation or what you hope to achieve.
Previous
Next
Submit
Press
Enter
9
Estimated Audience Size
Previous
Next
Submit
Press
Enter
10
Are you interested in any of the following?
Q&A with a scientist
Q&A with filmmaker
Educational resources for schools
Panel discussion with local experts
A focus on sustainable seafood or local food
Hosting a fundraising component
Featuring the event in local media or social channels
Other
Previous
Next
Submit
Press
Enter
11
Do you have any budget or funding to support the event?
Previous
Next
Submit
Press
Enter
12
Anything else you'd like to add?
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
12
See All
Go Back
Submit