Reel Grrls Television 2010

Tue, 12/15/2009 - 15:38 — maile

Reel Grrls, the award winning after-school media and technology program for young women ages 13-19, is partnering with SCAN Youth Media to create a grrl-produced televison and web series. Open to all video production levels!

Choose interesting topics, learn televison production, broadcast your opinions!

View some of Reel Grrls' past videos »

How to apply: Complete and submit the online registration form below. Then print and sign the Permission/Release Agreement and return it to Reel Grrls: 1409 21st Ave, Seattle WA 98122

Note: your application is not complete until you have submitted both the online form and the permission form!

Dates
Family orientation Saturday January 23rd, 10am-10:20 at SCAN
Class meets Tuesdays, January 26 - March 23, 4:00 PM - 6:30 PM at Reel Grrls
And monthly Saturdays: Jan 23, Feb 27, Mar 20, 10:00 AM - 4:00 PM at SCAN
Location
Tuesdays: Reel Grrls New Media Lab in Seattle's Central District, 1409 21st Ave, Seattle WA 98122
Monthly Saturday Meetings: SCAN, 1125 N 98th St, Seattle 98103
Who can apply
Girls ages 10-19 of all video production experience levels.
Cost
$300. Pay-what-you-can. No one turned away due to lack of funds.

Contact Info

Participant Name: *

Address: *

City: *

State: *

Zip: *

Phone: *

Participant Email: *

Parent/Guardian Name: *

Parent/Guardian Address, if different from above:

Parent/Guardian Phone: *

Parent/Guardian Email: *

Parent/Guardian Name 2:

Parent/Guardian Address 2, if different from above:

Parent/Guardian Phone 2:

Parent/Guardian Email 2:

Teen lives with :

Mother

Father

Guardian

Other

If 'other':

Optional Identity Questions

This information is for recording purposes only. It does not affect acceptance of your application in any way.

Other:

Program Application

Please tell us about yourself by answering the following question. Feel free to submit your answer in the form of a poem, script, photo, collage or video - anything that tells us about you.

Which TV show or shows inspire you? Why do you want to learn more about TV production?: *

Attachment (if any):

Upload a file to accompany your application.

Confidential Sliding Scale Payment Info

Reel Grrls is committed to serving grrls of all economic levels. All of our program fees are based on a pay-what-you-can system. You may also choose to pay in installments. Please make a minimum payment of $20 with your application.

How much can you contribute toward the $300? (please send with your payment voucher): * $ .00

Additional amount to contribute to the Reel Grrls Scholarship fund:: $ .00

Confidential Medical and Emergency Information

This information does not affect the acceptance of your application in any way. It purely enables Reel Grrls to create a safe and healthy environment for you as an apprentice, should your application be accepted.

Emergency Contact Name: *

Emergency Contact Relationship: *

Emergency Contact Phone: *

Medical History

Do you have any physical complaints or chronic illness at this time?: *

YES

Have you had injuries in the past (i.e., back, knee, etc.)? : *

YES

Are you currently taking medications of any kind?: *

YES

Dietary Needs:

I am a vegetarian

I don't eat dairy products

I have other dietary needs

Any additional information (diet or medical information)?:

Friend me on:

Facebook and my username is:

MySpace and my username is:

Twitter and my username is:

Flickr and my username is:

YouTube and my username is:

CAPTCHA

Are you a human or a machine? Just checking!

What is the third word in the phrase "wolep uyebas esatiro jiw"?: *

Lucia

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Reel Grrls Television 2010