Name
*
Grade
*
8
9
10
11
12
Team members, if applicable
Home Address
*
City
*
State
*
PA
Zip Code
*
School Name
*
School Address
*
School City
*
State
*
PA
School Zip Code
*
School Phone Number
*
Teacher Name
*
Teacher Email
*
What message do you hope to convey?
*
What is the impact of your project in your own life or the lives of others?
*
Please copy and paste the link (if you have video or music) to your project. If you need to email a picture or file, please state that in the box provided.
Please add your project here if it is a file.
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Parent Signature
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