School Name:

District:

County:

Address to send materials to:
Street:

City: Zip:

Name of video production program/course/club (this name will be used in print publications if selected):

Does your program produce a daily or weekly school announcements/news broadcast? Yes No

Does your program produce programs for Community Access Television? Yes No

If yes, please describe:

Does your program actively engage in cross-curricular projects with other students
and classrooms in your school? Yes No

If yes, please describe:

Cameras:

Camera 1 Make:
Camera 1 Model:

Camera 2 Make:
Camera 2 Model:

Camera 3 Make:
Camera 3 Model:

Audio:
Can you provide external audio equipment (wireless lav mics, boom mics, etc.) Yes No

If yes, please describe the equipment you anticipate using (make/model must be included):

Lighting
Can you provide lighting kits? Yes No

If yes, please describe kits and accessories:

Tripods
Can you provide tripods? Yes No

If yes, please describe tripods and accessories: