Video Essay Contest Local Association Coversheet (SA)

Use the tab key or mouse to move between answer fields.  Using the Enter key will submit your form.

  Deadline: February 1

*Association

Local Chair

Address

City

State

Zip Code

Phone Number

*Email

Valid email is required

Entries

Division 1

Division 1 Grades 4-8

Division 2

Division 2 Grades 9-12

Total

By submitting a video to this contest, students give TMTA license to copy, distribute, modify, display, perform publicly, and otherwise use and authorize others to use the video for any educational purpose and in any media, including broadcast.

*Confirmation

I agree to the previous statement.
I do not agree to the previous statement

Payment Instructions

When you receive email confirmation, a file will be attached.  You may open or save the file.  This is your confirmation page.

  Print confirmation page and mail it and your check to 

  Texas Music Teachers Association
 PO Box 831730
 Richardson, TX 75083-1730
 

  OR

You may pay by credit card using the Student Affiliate Activities Credit Card Payment Form upon completion of this form.

Create Your Own Form
using this Template

Want the ability to collect information with an
online form that looks like this one?