First Name:*

Last Name:*

Prefix:* Ms. Mr. Dr.

Title:

Organization/Business:*

Address Line 1:*

Address Line 2:

City:*

State:* AL AK AS AZ AR AA AC AE AF AM AP CA CO CT DC DE FL GA GU HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NM NJ NY NC ND MP OH OK OR PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY OTHER

ZIP/Postal Code:*

Country:*

Phone:*

Email:*

How did you hear about MPLC? Google Association Referral (Please specify) Trade or Industry Conference (Please specify) Press (Please specify) Advertisement (Please specify) Received Mailing (Please specify) Word of Mouth Studios Directly (Please specify) MPLC Field Representative (Please specify) Local Anti-Piracy Organization (Please specify) Other (Please specify)

What type of business or
organization do you represent?* Campground & RV Parks Camps & Conference Centers Corporations & Trainers Public Speakers & Industry Conferences Healthcare Childcare Centers & Programs Communal Living Schools Libraries Private Membership Clubs Government Agencies Customer Waiting Areas Religious Organizations Other

How do you plan to utilize films?* For entertainment purposes Training & Development All of the above Other

Do you plan to show movies
indoors or outdoors?IndoorsOutdoors

How many facilities do you
operate?

How many coaches do you operate?

How many people do you train
each year?

What is the capacity of your
facility?

Do you operate your program
year-round or seasonal?

What is your company's business
sector?

How many units are in your
complex?

What is the staff capacity of
your vessel or rig?

What is your full-time student
enrollment?

Post MPLC Rates:

Comments: