Organization Name*

Organization's Physical Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Organization's Email Address

ex: Info@yourdomain

Organization's Phone*

Do you have a current website?

No

Yes

Current Website Address

Contact Person's Name*

First Last

Contact Email Address*

Contact Phone Number*

Social Media Account(s)*

Do you have Facebook, Instagram, Youtube, etc?

No

Yes

Please list your Social Media accounts so we can reference them as needed

Please add any social media URL's that you want to be linked: FB, Instagram, Twitter, Youtube, Vimeo.

Do you have a logo that may occasionally be used in video shorts?*

If you don't have one or don't have it ready to send now, that's ok! You can get it to us later.

No

Yes

Upload your logo file

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 50 MB.

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