Link to PDF format

MEADA DVD Campaign Entry Form
Due by 4:00pm March 5th 2010
DVD formats accepted only

 

 

Name of DVD participants and year in high school:

 

 

Name of School District:    _____________________________________________

Contact Person: _________________________________

Phone Number:__________________________________

Parents must sign a release for student to participate in the DVD contest.
I’m the parent/guardian of the following student and give my permission for them to participate in the DVD contest sponsored by MEADA.

Student’s name: _____________________________________________________


Parent’s name:  ___________________________________ Date: _____________

Student’s name: ____________________________________________________


Parent’s name: ______________________________________Date:  ___________

Student’s name: ____________________________________________________


Parent’s name:  _____________________________________ Date: ___________

Student’s name: ____________________________________________________


Parent’s name: _____________________________________ Date: ___________

By signing this form you are giving MEADA permission to use this DVD in our media plan.