StoryTubes Contest Entry Form

Type of Entry:

YouTube TeacherTube

YouTube Video URL:
(what's this?)

TeacherTube Video URL:
(what's this?)

Title of Book Featured in Video:

Author of Book featured in Video:

Category:

Use Library, School, City and State Information for ALL Group Members

Group Number:

Primary Member Information (This will be the Main Contact Information for the Group)

Entrant's First Name:

Entrant's Last Name:

Grade:

Public Library Name:

School Name:

Enter 'None' for School Name if Adult Entrant

Entrant's City:

Entrant's State or Province:

Phone Number:

( )

I, the adult representative or adult entrant,
have read the rules and agree to comply:

(contest rules)

Adult's First Name:

Adult's Last Name:

Adult's Email Address:

Second Group Member Information

Entrant's First Name:

Entrant's Last Name:

Grade:

Public Library Name:

School Name:

Enter 'None' for School Name if Adult Entrant

Entrant's City:

Entrant's State or Province:

Phone Number:

( )

I, the adult representative or adult entrant,
have read the rules and agree to comply:

(contest rules)

Adult's First Name:

Adult's Last Name:

Adult's Email Address:

Third Group Member Information

Entrant's First Name:

Entrant's Last Name:

Grade:

Public Library Name:

School Name:

Enter 'None' for School Name if Adult Entrant

Entrant's City:

Entrant's State or Province:

Phone Number:

( )

I, the adult representative or adult entrant,
have read the rules and agree to comply:

(contest rules)

Adult's First Name:

Adult's Last Name:

Adult's Email Address:

Fourth Group Member Information

Entrant's First Name:

Entrant's Last Name:

Grade:

Public Library Name:

School Name:

Entrant's City:

Enter 'None' for School Name if Adult Entrant

Entrant's State or Province:

Phone Number:

( )

I, the adult representative or adult entrant,
have read the rules and agree to comply:

(contest rules)

Adult's First Name:

Adult's Last Name:

Adult's Email Address:

Fifth Group Member Information

Entrant's First Name:

Entrant's Last Name:

Grade:

Public Library Name:

School Name:

Enter 'None' for School Name if Adult Entrant

Entrant's City:

Entrant's State or Province:

Phone Number:

( )

I, the adult representative or adult entrant,
have read the rules and agree to comply:

(contest rules)

Adult's First Name:

Adult's Last Name:

Adult's Email Address:

Contest Entry Form
Best Viewed at 1024 x 768 Display Size

Entry Deadline: February 28, 2010 9pm PST

Contest Entry Form Best Viewed at 1024 x 768 Display Size

Entry Deadline: February 28, 2010 9pm PST

Contest Entry Form
Best Viewed at 1024 x 768 Display Size