Arizona Voices For Choice: Student Entry

Student's Name*

First NameLast Name

Student's Age*

Student's Current Grade (If in college, indicate year of study.)*

Name of Scholarship School*

Location of Scholarship School (City)*

Name of School Choice Program (select one only)*

Empowerment Scholarship Account (ESA)School Tuition Organization (STO)Charter School

Tell us about yourself. (Please answer with 25 words or more.)*

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Why did your family choose for you to attend this school? What are the top 3 things you like about your school, and why are each of them important? (Please answer with 75 words or more).*

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What difference has receiving a scholarship or School Choice made in your life? (Please answer with 25 words or more.)*

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Do you believe more families should have the same privilege you’ve had in receiving a scholarship or exercising School Choice? If so, why? What message would you like to leave for others who will view/hear your child's story? (Please answer with 50 words or more).*

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What does school choice mean to you? (Please answer with 25 words or more.)*

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Upload student's photo (2 mb maximum file size) PHOTO IS REQUIRED:

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Parent/Guardian Approval:

I, the undersigned, do hereby give permission to the American Federation for Children, Inc. (“AFC”) to use videographed interviews, written story submissions, and photographs of me or my child provided to AFC. I give AFC permission to use and publish any and all recorded or submitted story content on their website and in any material promoting AFC’s programs or for any other lawful purpose. I hereby hold harmless and release and forever discharge AFC from all claims, demands, and causes of action which I have or may have by reason of this authorization.Videographed interviews, written story submissions, and photographs of me will remain the property of the American Federation for Children and will not be sold for profit or used for commercial purposes. Any proceeds resulting from the use of the videographs, photographs, and written story submissions will be used only to support the mission of AFC. I understand that I have voluntarily provided photographs, interviews and story submissions and that neither myself nor anyone within my party will receive payment for future use of the photographs, interviews or story content.*

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I certify that I am 18 years of age or older.*

Yes

Name of Parent/Guardian*

First NameLast Name

Parent/Guardian Phone Number*

Area CodePhone Number

Parent/Guardian Email Address*

Confirmation Email

Signature*

QUESTIONS:

Email: emontenegro@federationforchildren.org

Click here for Eligibility Rules.

Please verify that you are human*

STUDENT STORY SUBMISSION FORM