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60 Utah PTA2018-2019 Reflections Local Leaders Guide
Nombre del Estudiante ___________________________ Grado _______ Años _______ Profesor ______________Nombre del Padre/Tutor _________________________________________________________Email ________________________________________ Teléfono ________________________Domicilio _______________________________ Ciudad ____________ EstadoCódigo Postal _________________
Cada presentación seguirá siendo propiedad del participante, pero la participción en este programa constituye elpermiso y el consentimiento irrevocables del participane para quela PTA exhiba, copie,reproduzca, amplíe, imprima, subconceda, publique, distribuya y cree obras derivadas con fines de la PTA. La PTA no se hace responsable de la périda o daños de las presentaciones. La solicitud de presentación en el programa PTA Reflections constituye la aceptación de todas sus reglas y condiciones. Acepto toda las afirmaciones anteriores y la reglas oficiales de National PTA Reflections.
FIRMA DEL ESTUDIATE FIRMA DEL PADRE/TUTOR LEGAL
DIVISIÓN DE GRADO (Marque una) CATEGORÍA DE ARTE (Marque una) ͏ PRIMARIA - Rojo (Preescolar - 2° grado) ͏ Coreografía de Danza ͏ Fotografía ͏ INTERMEDIO - Amarillo (Grados 3° - 5°) ͏ Producción de Cine ͏ Arte Visual 2D ͏ ESCUELA INTERMEDIA - Verde - (Grados 6° - 8°) ͏ Literatura ͏ Arte Visual 3D ͏ SECONDARIA - Azul (Grados 9° - 12°) ͏ Composición Musical ͏ ARTISTA ESPECIAL - Anaranjado (Todos los grados)
TÍTULO DE LA OBRA _________________________________________________________________
Detalles de la Obra (Danza/Cine: citar la música incidental; Música: músico/s/instrumentación; Literatura: cantidad de palabras
Fotografía/Artes Visuales: materiales y dimensiones) ____________________________________________________________
_______________________________________________________________________________________________________
Comentarios del Artista (Debe tener entre 10 y 100 palabrasque describan tu obra y cómo se relaciona con la temática) ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Este recuadro debe ser completado por la PTA antes de su distribución
Nombre de la PTA: _______________________________ IdentificaciÓn de la PTA: (8 dígitos) __ __ __ __ __ __ __ __
Reflexiones silla nombre: _______________________ Email: _______________________________ Teléfono: _____________________
Dirección de PTA: ________________________________________________ Consejo: _________________________ Región: ________
Fecha de membresía paga: ___________ Fecha de seguro pagado ____________ La fecha de vencimiento de los estatutos: _____________
STUDENTNAME_______________________________GRADE______AGE______TEACHER_____________
PARENT/GUARDIANNAME______________________EMAIL________________PHONE________________
MAILINGADDRESS_____________________________CITY______________STATE_________ZIP_______Ownershipinanysubmissionshallremainthepropertyoftheentrant,butentryintothisprogramconstitutesentrant’sirrevocablepermissionandconsentthatPTAmaydisplay,copy,reproduce,enhance,print,sublicense,publish,distributeandcreatederivativeworksforPTApurposes.PTAisnotresponsibleforlostordamagedentries.SubmissionofentryintothePTAReflectionsprogramconstitutesacceptanceofallrulesandconditions.IagreetotheabovestatementandtheNationalPTAReflectionsOfficialRules.
STUDENTSIGNATURE_______________________PARENT/GUARDIANSIGNATURE____________________
GRADEDIVISION(CheckOne) ARTSCATEGORY(CheckOne)¨PRIMARY-Red(Pre-K-Grade2) ¨DANCECHOREOGRAPHY¨PHOTOGRAPHY¨INTERMEDIATE-Yellow(Grades(3-5) ¨FILMPRODUCTION¨2DVISUALARTS¨MIDDLESCHOOL-Green(Grades6-8) ¨LITERATURE¨3DVISUALARTS¨HIGHSCHOOL-Blue(Grades9-12) ¨MUSICCOMPOSITION¨SPECIALARTIST-Orange(AllGrades)
TITLEOFWORK____________________________________________DETAILS_________________________
Ifbackgroundmusicisusedindance/film,citationisrequired.Includewordcountforliterature.Listmusician(s)orinstrumentationformusic.Listdimensionsforphotography/visualarts__________________________________________________________________________________________
ARTISTSTATEMENT(In10to100words,describeyourworkandhowitrelatestothetheme)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
ENTRYFORM
TobecompletedbyPTAbeforedistribution.
PTAName___________________________________________PTAID#(8Digits)________________________
REFLECTIONSCHAIRNAME___________________EMAIL__________________________________________PHONE_____________________
PTAADDRESS__________________________________________________COUNCIL______________________________REGION#______
DATEMEMBERSHIPPAID________________DATEINSURANCEPAID__________________BYLAWSEXPIRATIONDATE__________________
Region#_________
Council__________
FORMULARIO DE ENTRADA
STUDENTNAME_______________________________GRADE______AGE______TEACHER_____________
PARENT/GUARDIANNAME______________________EMAIL________________PHONE________________
MAILINGADDRESS_____________________________CITY______________STATE_________ZIP_______Ownershipinanysubmissionshallremainthepropertyoftheentrant,butentryintothisprogramconstitutesentrant’sirrevocablepermissionandconsentthatPTAmaydisplay,copy,reproduce,enhance,print,sublicense,publish,distributeandcreatederivativeworksforPTApurposes.PTAisnotresponsibleforlostordamagedentries.SubmissionofentryintothePTAReflectionsprogramconstitutesacceptanceofallrulesandconditions.IagreetotheabovestatementandtheNationalPTAReflectionsOfficialRules.
STUDENTSIGNATURE_______________________PARENT/GUARDIANSIGNATURE____________________
GRADEDIVISION(CheckOne) ARTSCATEGORY(CheckOne)¨PRIMARY-Red(Pre-K-Grade2) ¨DANCECHOREOGRAPHY¨PHOTOGRAPHY¨INTERMEDIATE-Yellow(Grades(3-5) ¨FILMPRODUCTION¨2DVISUALARTS¨MIDDLESCHOOL-Green(Grades6-8) ¨LITERATURE¨3DVISUALARTS¨HIGHSCHOOL-Blue(Grades9-12) ¨MUSICCOMPOSITION¨SPECIALARTIST-Orange(AllGrades)
TITLEOFWORK____________________________________________DETAILS_________________________
Ifbackgroundmusicisusedindance/film,citationisrequired.Includewordcountforliterature.Listmusician(s)orinstrumentationformusic.Listdimensionsforphotography/visualarts__________________________________________________________________________________________
ARTISTSTATEMENT(In10to100words,describeyourworkandhowitrelatestothetheme)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
ENTRYFORM
TobecompletedbyPTAbeforedistribution.
PTAName___________________________________________PTAID#(8Digits)________________________
REFLECTIONSCHAIRNAME___________________EMAIL__________________________________________PHONE_____________________
PTAADDRESS__________________________________________________COUNCIL______________________________REGION#______
DATEMEMBERSHIPPAID________________DATEINSURANCEPAID__________________BYLAWSEXPIRATIONDATE__________________
Region#_________
Council__________