MobiTV Content Provider Form

Thank you for your interest in MobiTV. We are always looking for new and innovative content and partnerships. To help us better understand your business, please fill out the form below. If we think there might be a fit, we will give you a shout. If you don’t hear from us right away, don’t despair. MobiTV is a rapidly growing company, and new opportunities are always on the horizon. If there’s not a fit now, there may be one in the future, so we’ll keep you in our database until such time.

	Fields marked with (*) are required fields.
Contact Information
*Contact Name:
*Title:
*Company:
*Size of Company:
Address:
*Contact Number:
*Email Address:
Fax:


Content Information
*Genre:
*Is the Content Promotional, Advertainment or other?
What is the demographic for your content:
Sex: Male Female Age: 1-6 6-12 12-18 18-25 25-35 35-45 45-60 60+

*Production Status :
Total number of hours for currently available content :
Additional hours that will be available through refresh (fill in one only): Daily Weekly Monthly
*Delivery Format :
*Is this content being produced today specifically for mobile devices? Yes No
*If this is broadcast TV, are the mobile rights for this content cleared? Yes No
*Are the wireless rights cleared ? Yes No
*Are the rights to deliver this through IPTV cleared? Yes No
How many subscribers to this content are there through:
Cable/Satellite: Broadcast:
Internet: Wireless:
In which countries do you have the rights to distribute this content?
In what languages?
In which country would you like to distribute your content?
Content Proposal:

By pressing the Submit button above, you agree to the following terms: MobiTV’s programming content is determined in our sole discretion, and receipt of this form from you does not create any obligation or commitment on the part of MobiTV relating to you or your content. Any such relationship shall arise only upon the execution of a written agreement by us. You agree that unless otherwise agreed to between us in writing, the information provided by you in this form or in other submissions to MobiTV, including but not limited to, data, questions, comments, suggestions, ideas, plans, notes, drawings, original or creative materials or other information, are non-confidential and you grant to MobiTV a nonexclusive, royalty-free, perpetual, irrevocable, and fully sublicensable right to use, reproduce, modify, adapt, publish, translate, create derivative works from, distribute, and display such materials throughout the world in any media now known or hereafter developed with or without acknowledgment to you in MobiTV's sole discretion and without compensation to you. You also grant to MobiTV the right to use your name in connection with the submitted materials.