Video Request Form
Name
*
Email - Please enter your email if you would like a copy of your submission.
example@example.com
Due Date for Draft
-
Month
-
Day
Year
Date
Due Date for Final
*
-
Month
-
Day
Year
Date
Please note, the team will evaluate dates and depending on the current workload/schedule. Certain exceptions will be made for rush projects. Please allow additional time if final copy isn’t provided and/or approved by compliance.
Brand
*
Messer ACA
Messer MA
Messer Group Division
Messer P&C
HP Freedom
Capstone ID Theft Protection
Capstone Health Network
Benchmark
E&O Depot
Other
Audience
*
Messer Agents
Messer Agent TOH (for DNCs) and Downlines
Non-Messer Agents
Client-Facing
General Public
Carriers/Carrier Reps
Internal Use
All-In, TPS, & CC Agents
Other
Back
Next
Save
Use
*
Meeting Presentation
Social Media
Email
Website
Advertisement
Other
Size(s) needed
*
Standard Horizontal (YouTube, Facebook, etc.)
Standard Vertical (TikTok, Reels, Shorts, etc.)
Square (Instagram, etc.)
Other
Desired date to film
*
/
Month
/
Day
Year
Date
Desired time to film:
Hour Minutes
AM
PM
AM/PM Option
Desired length of video
*
Video Title
*
Who's on screen?
*
General description, including call-to-action (CTA)
*
Will you need the teleprompter?
*
Yes
No
Verbiage for teleprompter
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Who is responsible for final approval if not you?
Additional Comments:
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