If you would like to have a screening with a discussion with the film producers after the screenings, please fill out the form below. 

Full Name *
Full Name
Phone Number *
Phone Number
What organization do you represent? (MSA, Mosque, etc)
Include organization/venue name and physical location of venue
(A payment given for services that are rendered nominally without charge. Average = $2500, you can sell tickets to make up the honorarium)
Interested screening date 1 *
Interested screening date 1
Please enter dates between March 25 2014 and May 31st 2014
Interested screening date 2
Interested screening date 2
Please enter dates between March 25 2014 and May 31st 2014
Interested screening date 3
Interested screening date 3
Please enter dates between March 25 2014 and May 31st 2014
Can you provide travel and lodging accommodations?