KET Education | School Video Project Entry Form

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KET School Video Project 2003/04 Entry Form

Please fill out this form, then PRINT IT OUT AND SEND IT with your video(s) by March 31, 2004, to:
Jeff Gray, KET, The Kentucky Network, 600 Cooper Drive, Lexington, KY 40502-2296, (800) 432-0951, ext. 7263, .
Only one form per school, please. If you need to list more titles, participants, or descriptions, just write or type on the back of the page.

School:
District:
County:
Address:
City:
State:
Zip Code:
Teacher(s):
Class or Group Name:
Video Producer(s):
Web Site:
Phone:
Teacher E-Mail:
Type of Class, Group, or Individual Producing the Video:
	School Video/Media Class Other Subject-Area Class School Video/Media Club Individual Student(s) STLP Group
Title(s) and Description(s) of Video(s):	Use other side of page if needed.
Our school gives KET, The Kentucky Network permission to use this submitted media in KET-produced video, audio, or Internet projects, including Internet web pages and Internet video streaming. Signed participant and subject releases have been collected and are on file at the submitting school or board of education office. Signature of School Principal or Authorized Representative: _________________________________________ Date: ____________ Printed Name: _____________________________________________ Title: _____________________________________________________

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Last Updated: Wednesday, 21-Apr-2004 20:42:42 EDT