Name *

Name of individual licensing on behalf of Client

First Name

Last Name

≤30 Seconds Usage *

Does total use in production total less than thirty seconds?

30 seconds total or less

Greater than 30 seconds

Date of licence activation *

Date from which footage licence will begin (inclusive), format DD/MM/YYYY

MM

DD

YYYY

Date of licence expiry *

Date after which footage licence will expire (inclusive), format DD/MM/YYYY

MM

DD

YYYY

Distribution Format *

Check all which apply

Broadcast

Online (including social media output)

Display

Streaming Service

All Platforms

Clearance Regions *

Check all which apply

National (restricted to viewership in registered country of end Client)

Europe

North America

Asia-Pacific

LATAM

Worldwide

Usage *

Select the genre(s) in which licensed footage will be used

Commercial

Documentary

Branded Content

Music Video

Non Profit

*

I have accepted the Terms & Conditions of booking, available below.

I acknowledge I am contracting with Jonathan Constantinou on behalf of my company, and am in a position of authority to do so.