2021 ESSA Physical Activity Student Showcase Form

* required field

About

Student physical activity performance videos to be showcased during the Mindful Movement breaks at the 2021 Virtual ESSA Conference February 23-24. Project submissions are due Friday, December 18th by 11:59 pm. Selected participants notified Friday, January 15th by 5 pm.

School Information

District or Charter Name *

School Name *

School Address *

Country *

Address 1 *

Address 2

City *

State *

ZIP code *

Instructor Information

Instructor's Name *

Instructor's Email *

Instructor's Work Phone

Instructor's Cell Phone *

Supporting Administrator Information

Administrator's Name *

Administrator's Email *

Submission Information

Student(s) Name(s) *

Student Project Description (200 Word Maximum) *

Project File (7 Minutes Maximum)

Project Video Link

Please include a downloadable project link (Google Drive, Ect...) if the file size is greater than 100MB or the system won't accept your file format.

Image/Photograph/Video/Media Release Form *

Please upload the signed Photograph/Image/Video/Media Release Assurance verifying all participating students have permission to showcase submitted work at the 2021 Virtual ESSA Conference. Use Required Template: https://www.azed.gov/sites/default/files/2020/09/Image%20Release%20Assurance%202021%20ESSA%20Conference_0.pdf

Leave this field blank