Tell us
about you and your organization |
First
and Last Name : |
|
Position
: |
|
Email : |
|
Phone
Number : |
|
Name
of the Organization: |
|
| Type of organization (store, hospital,
publication, etc) :
|
|
For
Profit
Non-for-Profit |
Address
: |
|
City
/ State / Postal Code : |
|
Country
: |
|
Material
and Information Being Requested |
What
are you requesting? (copyright release of pictures or
content, interview, etc) |
|
Brief
description of the purpose for the request :
(i.e., presentation, website, publication, TV Program, etc) : |
|
Who
is the target audience? : |
|
Do
you or your organization currently use the Zaky? and if
so, who uses them and how many do they use? |
|
When
will you use the material requested and for how long? |
|
| When do you need the
requested material from us (date)? |
|
Would
you send Zakeez, Inc. a copy of the publication/
presentation/tape/etc to be included in our website and marketing/education
materials? : |
|
| Is
there something else that you want to tell us? |
|