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Home
2023 Title IV-A & B Symposium
2023 Title IV-A & B Symposium
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About
The Arizona Department of Education invites you to submit videos to be featured at our Title IV-A & B Symposium: Engage- Inspire- Support on September 13-14, 2023. Submissions May Include: Highlights of school programs supported by Title IV-A & 21st Century CCLC funds Student Guided Movement/Exercises (seated workouts, yoga, dance, your imagination is the limit...) Student Virtual Performances or Media (Music, Dance, Theatre, Film, Animation, Spoken Word, your imagination is the limit) Please complete the form below:
School Information
District or Charter Name
*
School Name
*
School Address
*
Country
*
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Caribbean Netherlands
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo (Brazzaville)
Congo (Kinshasa)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong S.A.R., China
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao S.A.R., China
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
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Mauritius
Mayotte
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Moldova
Monaco
Mongolia
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Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
North Korea
Norway
Oman
Pakistan
Palau
Palestinian Territory
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican
Venezuela
Vietnam
Wallis and Futuna
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Zimbabwe
Address 1
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Address 2
City
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State
*
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Connecticut
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District of Columbia
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Oklahoma
Oregon
Pennsylvania
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South Dakota
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Texas
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Armed Forces (Americas)
Armed Forces (Europe, Canada, Middle East, Africa)
Armed Forces (Pacific)
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
Virgin Islands
ZIP code
*
Instructor Information
Instructor's Name
*
Instructor's Email
*
Instructor's Work Phone
Instructor's Cell Phone
*
Supporting Administrator Information
Administrator's Name
*
Administrator's Email
*
Submission Information
Type of Showcase
*
Highlight of Title IV-B 21st CCLC Program
Highlight of Title IV-A Program
Student Virtual Performance
Student Media Performance
Student Physical Activity Video
Video Submission Requirements
*
Please check each box in the section below as all submissions must align with the following requirements:
Video clearly shows students participating in Title IV-A & B programs or performances/presentations/physical activity
Video is in alignment with ADE's mission and vision
Audio is clear and easily understood (captions are included, if necessary)
Video is high-quality/high-resolution
Student(s) Name(s)
*
Student Project Description (200 Word Maximum)
*
Project File (5 Minutes Maximum)
Upload
Project Video Link
Please include a downloadable project link (Google Drive, Ect...) if the file size is greater than 100MB or the system won't accept your file format.
Photo Release
*
Photo Release: I hereby grant the irrevocable right and permission to The Arizona Department of Education to use a photograph or video of participating students' & teachers' work for publication in the news media or electronically via the internet or in other displays for education, nonprofit, visual art publications, and exhibitions.
Agree
Disagree
Distribution Release
*
Distribution Release: I understand and agree that such photographs and videos of participants may be placed on the internet. I also understand and agree that participants may be identified by name, grade, and the school district in printed, internet, and broadcast information that might accompany the photographs or videos. Participants waive the right to approve the final product. All submissions must be of appropriate content. ADE reserves the right to not-display images that fail to meet the standard of appropriate content.
Agree
Disagree
Liability Release
*
Liability Release: Participants acknowledge they do not expect to receive compensation. Participants hereby release, and fully discharge The Arizona Department of Education, The Arizona Art Education Association, and The Council for Art Education from any claims, rights, damages, and liabilities arising out of or related to any claims for invasion of privacy, appropriation of likeness, or defamation.
Agree
Disagree
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