Thanks for your interest in screening Amplify Her! Please answer a few questions so we understand more about you.
How I'd like to help... *

Please choose the one that best suits you.

What type of event are you MOST interested in putting on: *

First Name *

Last name: *

Email *


Your organization

Do you represent an organization/association that we can possibly partner with?
Requested screening location *

(City, State/Province, Country ...outside North America suggestions are welcomed)
Possible screening venue

Do you have an idea for the perfect venue? A/V requirements not necessarily a deal-breaker - in some cases, we can bring in all required equipment.
Tell us more about your town / organization / screening idea

Please include number of attendees, and anything else you think we should know.
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