Safe Jobs for Youth Month Video Contest Entry Form
Entries must be submitted by Monday, January 9, 2017, 5:00pm
Title of Production:
Your answer
Subject of My Video:
Contact Information
Video Producer's Name:
Your answer
Age:
Your answer
Address:
Your answer
Student's home number:
Your answer
Student's cell number
Your answer
Student's email:
Your answer
School:
Your answer
Teacher:
Your answer
School Address:
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Teacher's phone number:
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Teacher's email:
Your answer
Is this a team or individual entry?
Contact Student or Teacher?
Copyright Clearances & Information:
List all audio and visual sources (music, video footage, etc...) and Permissions ( Please download the video permission form on our website and email a signed copy to joselyn@berkeley.edu or mail to address provided)
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Video Link (Please send a YouTube link) *If you would like to submit your video via email, please contact joselyn@berkeley.edu
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