Enrollment is Now Open for the 2021-2022 School Year!

Movie Licensing Request Form

Thank you for your interest in Movie Licensing for your school or organization. BLaST IU17 is able to offer your district an exclusive discounted rate for a limited time annually until July 20, 2021, so act now to lock in your district for the 2021-22 academic year! Please fill out the following information about your school/district to see your discounted rate. Movie Licensing is based per building. Once you have finished and hit submit you will receive an email confirmation.

A PURCHASE ORDER IS REQUIRED and will only be accepted AFTER JUNE 30th.
Once we receive a PO, the license cannot be withdrawn and refunds will not be granted.
Please submit PO's to Renee Peluso at rpeluso@iu17.org

Building Address (To Send License Certificate)
Street Address
Additional Address Details
City
State/Province
Zip/Postal
Billing Address
District/Business Office
Attention To:
Street Address
City
State/Province
Zip/Postal
The license effective dates will be 7/1/21 – 6/30/22. The invoice and official Movie License Certificate will be mailed at the conclusion of the enrollment period to the school and the address provided in this form. All payments will be made to BLaST IU17. Should you have any questions please contact Renee Peluso at rpeluso@iu17.org or call 570-323-8561 x1050.