Flip Video Spotlight - Application

1. Submit this application. Please review our guidelines.

2. Flip Video Spotlight reviews the application and determines eligibility.

3. Approved organizations will receive instructions on how to make Spotlight purchases.

Pure Digital Technologies LLC reserves the right to make all determinations regarding eligibility for participation and continuing participation at its sole discretion and to amend these requirements at any time and for any reason. All use of this web site will be subject to the Terms of Use and Privacy Policy for this web site and all purchases under the Program will additionally be subject to the Terms of Purchase.

NOTE: All fields are required

Organization Information

My organization has 501(c)(3) status:

Organization Name:
(If under fiscal sponsorship or a satellite office, put SPONSORING ORG NAME in Organization Name box and YOUR ORG NAME in DBA box)

Doing Business As (DBA):

Organization Description :
(No more than 2 sentences please.)

Organization Type:

Website:

Mailing Address:

City:

State:

Zip Code:

Phone Number:
(Sample 415-090-0000)

Federal Tax ID (XX-XXXXXXX):

Putting Video to Work

How will video contribute to your organization's goals?

How do you plan to incorporate video into your projects this year?

How many camcorders could your organization use effectively this year?

How many camcorders does your organization plan to purchase this year?

Does your organization post video online?

Do you accept online donations?

Where did you hear about the Flip Video Spotlight program?

Contact information

CEO/President/Executive Director:

Email Address:

Organization Contact Person:

Title:

Email Address:

Phone Number:
(Sample 415-090-0000)