ESTIMATE REQUEST FORM

Date Submitted:

Date/Time Needed By:

Requestor's Name:

Client:

Product:

Project Name:

Job #:

Email:*

Shoot Date:

Performer Location:

Air Date:

# Spots:

Lifts/Versions:

TV: TV

Radio: Radio

Internet/NewMedia Only: Internet/NewMedia Only

Estimate Session Fees: Estimate Session Fees

Estimate Use Fees: Estimate Use Fees

Other (Specify): Other (Specify)

# Of On-Camera Principals @ Scale:

# Of On-Camera Principals Over Scale:

# Of Voice Overs @ Scale:

# Of Voice Overs Over Scale:

# Of Extras @ Scale:

# Of Extras Over Scale:

Amount(s) $:

Amount(s) $:

Other (Specify - e.g., dancers, stunts):

Other (Specify - e.g., drivers, celebrities):

Additional Info:

(eg., OT, night, weekend, travel, fittings, wet/smoke, minors, music, ect.)

Media Info:

(type of use, flight dates, cable networks, markets, number of Class A users, ect.)

Any Additional Info:

Date of Approval:

Please attach script and/or storyboard

Submit completed form to EMS by fax or click send to email. Via fax 214-637-0635