Movie Licensing Pro-Rated 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 pro-rate for a limited time until November 1, 2018, so act now to lock in your district for the 2018-19 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.

Building Address
Street Address
Additional Address Details
The license effective dates will be 11/1/18 – 6/30/19. This registration is only to secure your school and/or district in the BLaST IU17 consortium discounted pricing for movie licensing. You do not need to send a PO for this. Once you submit your approval it will act as an official PO and you will receive an email confirmation. The invoice and official Movie License Certificate will be mailed to the school and address provided in this form. All payments will be made to BLaST IU17. Should you have any questions please contact Audra Mazzante at or call 570-323-8561 x1029.