Please fill out the Licensing & Acquisitions Services Request Form below and the account representative will contact you as soon as possible. You will be sent marketing material as well as video samples. Your information will be kept confidential. We do not share your information with anyone outside of our company.

Licensing & Acquisition Service Request Form Name: Company: Position: Industry: E-mail Address: Phone: Interested in Licensing or Acquiring What Title(s): 60-Second Housecall (Licensing) Tattoo Nation (Licensing) One-Minute Workout with Lacy Weston (Licensing) Kifaru Native American Collection (Licensing) Lisa Firestone (Licensing) Other    If other, describe Provide Notes:

117 E. Amelia Street Orlando, FL 32801

Tel: (321) 256-1146 Fax: (407) 386-3442