RSA NY STUDENT VIDEO CONTEST REGISTRATION FORM
Registration closes February 28, 2023
SCHOOL INFORMATION
STUDENTS CHOOSING TO SUBMIT AN ENTRY ON THEIR OWN MUST IDENTIFY A FACULTY/STAFF MEMBER TO ASSIST IN THIS REGISTRATION FORM
SCHOOL DISTRICT
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PLEASE DO NOT USE ABBREVIATIONS
FACULTY/STAFF MEMBER NAME
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First Name
Last Name
FACULTY/STAFF MEMBER EMAIL
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example@example.com
TITLE OF VIDEO
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PARTICIPANTS
PLEASE SELECT WHETHER A CLASS, A CLUB, OR A STUDENT IS SUBMITTING INDEPENDENTLY (OR A GROUP OF STUDENTS ARE SUBMITTING INDEPENDENTLY).
GRADE LEVEL
Grades K-8
Grades 9-12
IS THIS AN INDEPENDENT STUDENT ENTRY OR GROUP/CLASS ENTRY?
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Please Select
INDEPENDENT STUDENT(S) ENTRY
CLASS ENTRY
CLUB ENTRY
OTHER
IF YOU SELECTED CLASS/CLUB/OTHER ABOVE, PLEASE DEFINE:
PARTICIPANTS' GRADE (if more than one, please separate by commas - for example 10, 11, 12)
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TOTAL # OF STUDENT PARTICIPANTS (STUDENTS WHO WILL RECEIVE A PRIZE IF AWARDED)
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PLEASE LIST FULL NAMES OF ALL PARTICIPANTS FOR CERTIFICATES (STUDENTS WHO WILL RECEIVE A PRIZE IF AWARDED)
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DATE OF 2023 AWARDS NIGHT (RSA NY WILL PRESENT AWARDS IN PERSON)
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Month
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Day
Year
Date
NOT SURE OF AWARDS DATE
SELECT IF NOT SURE
VIDEO RELEASE REQUEST
PLEASE ENSURE STUDENTS AND OTHERS CAPTURED IN THE VIDEO HAVE AGREED TO VIDEOGRAPHY. VIDEOS WILL BE SHARED ONLINE, TO VARIOUS AUDIENCES, AND WILL BE FEATURED IN FUTURE RSA NY MAILINGS.
I UNDERSTAND
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PLEASE SELECT THAT YOU HAVE READ OUR VIDEO RELEASE REQUEST
VIDEO SUBMISSION
PLEASE SHARE YOUR VIDEO LINK BELOW. YOU CAN CHOOSE YOUTUBE, VIMEO, OR ANY OTHER VIDEO SERVICE THAT PROVIDES A SHAREABLE LINK. *Make sure your video is either public or made shareable for viewing/judging purposes*
COPY/PASTE VIDEO LINK BELOW:
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Submit
Should be Empty: