What is your organization/community's name (for community, the town name is fine)?
Your answer
Where would you like the screening to be held? If you do not have a location, write "I don't know."
Your answer
What is your first date preference for a screening? Please note that as most of us are full-time undergraduate students, our availability is greatest on weekends.
MM
/
DD
/
YYYY
What is your second date preference for a screening? Please note that as most of us are full-time undergraduate students, our availability is greatest on weekends.
MM
/
DD
/
YYYY
What time would you prefer your screening to start?
Time
:
AM
PM
What is the best way to contact you about your screening?
Clear selection
Based on what you selected above, please enter your email address/phone number so we can contact you.