Educatie Formulier

What is your preferred date?*

Preferred time (after 09:30)*

Which class or classes are you bringing? Please include the grade and year.*

What is the age of the students?*

Number of students.*

Number of chaperones.*

Film choice*

Can you explain your answer above?*

What’s the reason for the film screening?*

Every school screening includes a 5-minute introduction and a 5-minute discussion afterwards. Would you like a more in-depth screening? If so, please choose from the options below.

What’s the name of your school?*

BRIN-number*

Name contact person*

Contact person’s phone number?*

Contact person’s email?*

How would you like to pay?*

Please fill in the financial details below