Footage Licensing Request Form

Please tell us about the intended use and audience for the footage you are requesting.

Penn State Media Sales licenses education multimedia; some material is restricted to specific audiences, or for a restricted period of time. Media Sales will not license footage, which will be used in a derogatory or inappropriate manner toward the author, the subject, or the University. Media Sales reserves the right to deny or release any request for reuse.

Contact Information

Business Name:

Contact Name:

Email Address:

Telephone Number:

Fax Number:

Is this a work for hire? If so please provide the name of the end user.

Address 1:

Address 2:

City

State/Province/Territory:

Zip/Postal Code:

Country:

Terms

Titles Requested:

Usage Type:

Hold the Control Key (Windows) or
Command Key (Mac) to select multiple items.

Number of Uses Requested (i.e. number of broadcast flights):

Length in Years of Requests (or in perpetuity):

Are you requesting home video release rights?

Production Information

Name (or working title) of Proposed Production:

Estimated Footage Time Requested (in seconds):

Brief description of project, its purpose, and the intended audience. (A detailed treatment is preferred.)

DVD/VHS/CD Sales Questions

What will be your estimated price point in $USD?

What quantity do you expect to sell annually?

What is the approximate total length of your production?

Who is your target market?

Additional Comments:

Penn State Media Sales
is an exclusive distributor of renowned educational films contributed by post secondary institutions, individual academic professionals, and commercial distributors.

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Contact Us

Penn State Media Sales
171 Outreach Building
University Park, PA 16802

Email: mediasales@outreach.psu.edu
Phone: (800) 770-2111
Fax: (814) 865-3172