Alaska Teen Media Clubs
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1. Application

This application is to be filled out by students interested in starting an Alaska Teen Media Institute Club.

For more information visit http://alaskateenmedia.org/drupal/faq.

1. Club Member

Club Member Name:
Age:
School:
Birthdate:
Phone:
Email:

2. Club Member

Club Member Name:
Age:
School:
Birthdate:
Phone:
E-mail:

3. Advisor

Advisor Name:
Job Title:
Place of Employment
Work Phone:
Additional Phone:
E-mail:

4. Why would you like to start an ATMI club?!

Why would you like to start an ATMI club?!

5. Please list equipment and computers you already have which might be useful in media production.

Please list equipment and computers you already have which might be useful in media production.

Alaska Teen Media ClubsExit this survey

1. Application

Alaska Teen Media Clubs
Exit this survey