Order Form: Public Performance Site License from Movie Licensing USA

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Due to circumstances caused by COVID-19, we are pleased to offer you an extended license for the cost of 12 months. There are no changes to the pricing from 2019. The license extension covers August 1, 2020-December 31, 2021. Please let us know if you will be planning to renew your subscription by filling out this intent to purchase form no later than October 23rd. Note: you must complete this commitment to renew your subscription in order to be eligible to host outdoor screenings.

In order to secure a deep discount for our members, CLC places a group order with Movie Licensing USA and pays in advance for all licenses. The invoice for your portion of the group order will be sent out in mid to late October. If you'd like to be invoiced sooner, please indicate that on your order form in the comments section. Please be aware that we must receive payment by December 31, 2020. We will charge a 5% late fee for invoices that are not paid within 60 days.

Please note that when purchasing a license, CLC membership must remain current for the duration of the license period. CLC reserves the right to impose additional charges equaling the value of savings received on license(s) if membership lapses.

Thank you for your understanding and prompt payment.

Email *

Contact Information

Provide information for the person ordering. You will have an opportunity to add a billing contact later.

Library and branch(es) covered by license *

Contact Name *

Work Phone *

Price & Confirmation

Price - Please refer to the following table for pricing. Pricing has not changed from last year. Note: if your library needs branch licenses or requires a special custom quote, please either refer to your invoice from 2019 or contact jvannostrand@ctlibrarians.org for the total cost.

Use the chart to determine your price by population served and confirm by typing the amount you agree to pay below. *

Confirmation *

By accepting this quote, I understand that I am authorizing the Connecticut Library Consortium to place an order on behalf of my library. I agree to pay for this product at the quoted price within 60 days of the invoice date. I understand that a 5% late fee will be charged if payment is not made within 60 days.

I do not wish to renew my subscription.

Required

Billing

Please fill out the information below so that we can send the invoice to the proper person. We will email the invoice before your subscription period start date. If you require a paper invoice, we will send one upon receiving a purchase order.

Billing Contact Name *

Same as contact name above.

Other:

Billing Contact Email *

Same as contact email above.

Other:

Billing Contact Phone Number *

Same as contact phone number above.

Other:

Billing Contact Address *

Please Include: Street Address, City and Zip. Example: Connecticut Library Consortium, 234 Court St, Middletown CT 06457

Purchase Order

If you will be using a P.O., please provide P.O. number if you have it.

Do you have any questions or comments?

A copy of your responses will be emailed to the address you provided.

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