Request to Use Video in the Classroom
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Teacher's Name
Your answer
Title of Video
Your answer
TV MA and R videos or not permitted.
Length of Video
Your answer
Date
MM
/
DD
/
YYYY
List the objectives (by name and number) that will be covered
Your answer
Provide a brief description of the student activity(ies) associated with this film
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A properly purchased or rented videotape may be used in a classroom setting in conjunction with face-to-face instruction. These criteria must be met: 1. Must take place in a classroom or place of instruction in a nonprofit educational institution. 2. Only teacher and students can be in attendance. 3. Must be a face-to-face teaching activity. 4. Copy of the video must be legally made or acquired. I am following copyright guidelines and laws.
I understand that this video is not to be used for entertainment or reward.
I have previewed the video and verify that the content and language are appropriate for my students and for school use.
This video is relevant to the curriculum and specific educational objectives of the class and is a productive use of class time.
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