Custom Video Request Form Question Title * Please provide your contact information Name Address City/Town State ZIP Code Email Address Phone Number Question Title * What school/organization are you with? (if applicable) Please write NA if this is for personal/family use. School or Organization Question Title * When do you need the video(s) by? Date / Time Date Question Title * What is the age of your audience? Are there any special needs we should be aware of? Question Title * Who should we address in the video? (ex, "Hello, Bay Harbor First Graders!" or "Hello, Summer Campers!" etc.) Question Title * What is your main goal of these videos? What do you want the audience to get out of it? For example - is it just general animal information, like where they live, what they eat, how they survive in the wild, etc. Do you want the audience to feel like they are learning about "behind the scenes" info, like how we take care of these animals at the Zoo? Or, for older students, should we focus more on the conservation history surrounding the endangered species, etc. Question Title * Each video can be customized to meet your audience's needs. Videos feature one animal species and will typically be 5-7 minutes in length. They cost $50 each. How many separate videos do you want us to produce for you? 1 2 3 4 5 more than 5 Question Title * Do you want any supplemental activities for your videos? These are things like crafts or games, where we provide you with templates and instructions, and you would lead your students in these activities on your own time, after watching our video(s). Supplemental activity fees start at $25. Yes, I would like just one supplemental activity for my students Yes, I would like one supplemental activity PER VIDEO for my students No, thank you; I just want the videos I am unsure; please contact me to discuss the options Yes, I want this many supplemental activities (please specify a number) Next