The Pink Room Screening Request Question Title * 1. How did you hear about "The Pink Room" documentary? Question Title * 2. When would you like to have a Screening of The Pink Room? (specific date, dates, or generic month) Question Title * 3. For what purpose would you like to screen The Pink Room? Awareness Raise Funds for Agape International Missions Raise Funds for something else Other (please specify) Question Title * 4. What avenues of promotion can you use for the screening? Website Facebook Twitter Other Social Media Newsletter Posters Mailers Promotion at Event Video Radio Advertising Other (please specify) Question Title * 5. What location would you like the Screening to be held at? Question Title * 6. What volunteers could you have available for the Screening? Audio/Video/Tech Greeters Event Host Facility/Operations None Other (please specify) Question Title * 7. I would like to have my Pink Room Kit mailed to: Name: * Company: * Address 1: * Address 2: City/Town: * State/Province: * ZIP/Postal Code: * Country: * Email Address: * Phone Number: * Question Title * 8. I would like to order a Pink Room screening kit for the following number of people (cost does not include shipping). Payment is not required at this time, you will be emailed an order form with total cost. 50 ($35) 100 ($50) 150 ($65) 200 ($80) 250 ($95) 300 ($110) 350 ($125) Other (please specify) Question Title * 9. Would you help AIM by holding a fundraiser during your screening? If yes, we can send you a combined package of 40 3Strands bracelets. Each package is $120, this covers the cost of bracelets. You sell them for $10 each. Whatever you don't sell, you return and we will credit you for the amount you return. Yes! I'd love to help AIM by holding a fundraiser Sorry, not this time Done