Materials Assistance Request Form
Contact Information:
First Name
Last Name
Title
Company
Phone
Email Address
Cell
Website
Address 1
Address 2
City
State
-- Please Select --
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
Country
Project Information:
Title of Project
Materials Requested
Location Photos
Production Directory
Maps
Visitor Guides
If requesting location photos, please list types of locations needed:
Date Materials Request By (mm/dd/yyyy):
Confidential Project?
-- Please Select --
Yes
No
Type of Project
-- Please Select --
Animated Feature
Animated Short
Commercial/National
Commercial/Regional
Commercial/Local
Corporate/Industrial
Documentary
Feature Film/Studio
Feature Film/Independent
Music Video
Reality/Documentary Style Television Series
Still Photography
Student/Short Film
Television Series
Television Episode
Video Game
Web Based Program
Other
Phase of Production
-- Please Select --
Development
Early Pre-Production
Pre-Production
Production
Post Production
Production Start Date (mm/dd/yyyy)
Production Wrap Date (mm/dd/yyyy)
Total Shoot Days
Approximate Budget
Attach Script or Reference Photo
Brief Description of Project:
Additional Information or Request
Materials Assistance Request Form