Collaboration Request

Collaboration Request

Thank you for your interest in working with Fujifilm North America. Please fill out the form below and you will be contacted once we have reviewed the proposal. Please allow 2-3 weeks for a response.
Full Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState/Province

Zip CodeCountry
E-mail*
Where can we find you online? (Please use the "+" button to add all applicable platforms)*
Fujifilm X SeriesFujifilm GFX SeriesFujifilm FinePixInstax Instant CameraInstax Smartphone PrintersOne Time Use (disposable) Cameras or Film
Who is your primary audience? (Please use the "+" button to add all applicable platforms)*
Why are you interested in working with our brand?*
Free ProductLoaner EquipmentExposure/Promotion of Your WorkLicensing of Your WorkOther
What other brands are you currently working with (if any)? What do you do for them? *
Would you be willing to create video for us? Can you do this independently with direction?*
YesNo
YesNo
Please verify that you are human*
What are the dates of your event or sponsorship (if applicable)?

MonthDayYear
Deadline for a response (if any).

MonthDayYear
Instax instant camerasInstax Share smartphone printersFujifilm X series camerasFinePix XP adventure camerasGFX medium format camera systemOne time use (disposable) cameras or filmOther
ProductSponsorship (name only)CashProduct + cashOther
If cash or product, please specify amount requested.
Opportunity to demonstrate productExposure on social media (Facebook, Twitter, Instagram, YouTube)Review on website or blog postReview or feature in print publicationEndorsement by celebrity, influencer or professionalOther
Tell us about your audience, including age, gender, interests, etc.*
How many people will your collaboration reach (estimate or historic data)?
City, State or Province*
List your social profiles and how many followers for each. (eg. instagram @instax: 4,000 followers)
Website/Blog URL
Please List your blog or website statistics (ie. unique monthly views, subscribers, etc.)
Tell us specifically about your proposal and what you're asking from Fujifilm.*
Attach your media kit or proposal presentation

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