EVC 2017 Youth Powered Video Summer Institute Registration Form
Registration is based on a first come first serve basis, so register early! Registration fee includes a copy of Youth Powered Video, 50 standards based lessons, accompanying handouts and assessments!

For more information contact Mary Grueser at 212-465-9366 ext. 103 or mgrueser@evc.org.

Sign in to Google to save your progress. Learn more
Name: *
Email Address *
Contact Phone Number *
School/Org/Affiliation Name: *
School/Org/Affiliation Address *
School/Org/Affiliation City, State and Zip Code *
Subject(s) and Grade(s) Taught: *
Number of Years Teaching or in Current Role
Are you interested in receiving P Credit? *
How do you hope to incorporate video production into your work with students (if you’re not yet sure totally ok to leave it blank!)?
What is your experience with video production and/or media analysis? (no experience required)
Registration Fees *
Registration is not complete until tuition is received, and must be received by July 31, 2017. Space cannot be held for incomplete applications.  Your initials below indicate that you have read and agree to the registration policy.
Refund Policy *
Cancellations can be made by calling Mary Grueser at 212-465-9366 ext. 103. Cancellation prior to August 3rd will result in a $425 refund. Cancellation between August 3rd and August 7th will result is a $300 refund. No refunds for cancellations after August 7th.  EVC reserves the right to cancel the Institute due to lack of enrollment. In the case of cancellation, participants will receive a full refund. Your initials below indicate that you have read and agree to the registration information and understand the refund policy.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Educational Video Center. Report Abuse
Google Forms