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The Competition/Entry Form

Remember: Entrants must comply with all rules or your video will be disqualified.

Use the form below to enter online. If you would rather enter by mail, use this form.

Please fill in all fields marked with a *
Team Captain Information
First Name *
Last Name *
Street *
City *
State *
ZIP *
E-mail *
Phone *
High School Information
High School Name *
Address *
City *
State *
ZIP *
Teacher Information
Name
Phone
E-mail
Team Member Information - Should your video be selected as a winning entry all scholarship money will be evenly divided amongst all team members.
Team Member 1
Name
E-mail
Team Member 2
Name
E-mail
Team Member 3
Name
E-mail
Team Member 4
Name
E-mail
Commercial Information
Title of Commercial *
Courageous Persuaders® Free-Use Music Track Number or Indicate Which Team Members Composed and Performed Any Original Music (if you used GarageBand as an element of your Original Music, you must indicate this here) *
How did you hear about the Courageous Persuaders® Program? Click all that apply.
Teacher
Poster
Television
Newspaper
Radio
Internet
NAIAS
Other
Upload video entry to the Internet (i.e., YouTube, Vimeo, or SchoolTube). You must upload your commercial before submitting your entry form to Courageous Persuaders®. Once you upload your commercial on the Internet, simply copy the URL and paste it below.
Link to Commercial *