Short Film Competition

Contact Information

Name*

First

Last

Personal Email Address*

Please include a PERSONAL email address. Please do not include a school email address.

Phone Number*

Please enter your phone number with dashes. Example 801-345-6789 and not 8013456788

School Information

School Name *

Please enter the full name of your school. (example: Central Davis Junior High School, not Central Davis Jr. New London High School, not New London. Ogden Preparatory Academy, not Ogden Prep)

LIA Teacher Name *

Please enter the first and last name of your LIA teacher. Please do not enter Miss, Mr., or Mrs. Example: Tom Johnson, not Mr. Johnson. Susan Brinkley, not Miss Brinkley

Grade*

Please indicate your grade.

Please select6th7th8th9th10th11th12th

State*

Which state do you live in?

Please selectArizonaCaliforniaColoradoConnecticutFloridaIdahoIllinoisIowaNevadaNew YorkOregonUtahWashington

Personal Work

Personal Work*

I certify that my (our) submission is my (our) own work and is in no way copied or plagiarized from any other source.

LIA Right of Use

Your short film may be used by Latinos In Action for promotional purposes. By submitting your work you agree that LIA has the right, without any compensation to you, to publish all or part of your short film online, on social media, in presentations and in any other way to promote the organization, raise funds, and for all other purposes deemed necessary by Latinos In Action.

LIA Rights*

I understand that LIA can and may use all or part of my short film as it deems necessary without compensation to me.

Unlisted YouTube Link*

Please include a link to your short film below. The link should be an unlisted YouTube video.

Filmmakers*

Please list the full name(s) of each student responsible for the creation of the short film, including yourself. If selected, the person who submitted the form will receive any potential prize awarded. If selected, ALL students listed will be recognized at the LIA Conference.

Thank You!