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ReelLIFE SCIENCE 2023 Application Form
Please fill out the Application Form below so your video can be considered for the ReelLIFE SCIENCE 2023 video competition. Best of luck!
SECTION 1: YOUR SCHOOL OR YOUTH ORGANISATION
Tell us about the school or youth organisation you are representing with your ReelLIFE SCIENCE video.
School or Youth Organisation
*
Please select
Primary School
Secondary School
Youth Organisation
With this entry, are you representing a school or youth organisation?
School or Youth Organisation Name
*
Are you a teacher, youth worker or participant?
*
Please select
Teacher
Youth Worker
Participant
Are you a young person (under 18) participating in a school or youth group, or an adult assisting with the application?
Teacher/Youth Worker Name
*
First
Last
We need to be able to contact an adult (teacher/youth worker) about your video if it is shortlisted for a prize. Please do not use your own name unless you are a teacher or youth worker.
Teacher/Youth Worker Email
*
We need to be able to contact an adult (teacher/youth worker) about your video if it is shortlisted for a prize. Please do not use your own email address unless you are a teacher or youth worker.
Teacher/Youth Worker Phone
*
We need to be able to contact an adult (teacher/youth worker) about your video if it is shortlisted for a prize. Please do not use your own phone number unless you are a teacher or youth worker.
Number of Students/Youth Members Involved
*
Class(es)/Year(s) Involved
*
Junior Infants
Senior Infants
First Class
Second Class
Third Class
Fourth Class
Fifth Class
Sixth Class
First Year
Second Year
Third Year
Fourth/TY
Fifth Year
Sixth Year
For schools, tick all classes/years involved in making the video
Address - Street
*
Please enter the street address of your school or youth organisation.
Address - Town
*
Please enter the town address of your school or youth organisation.
Address - County
*
Please select
Antrim
Armagh
Carlow
Cavan
Clare
Cork
Derry
Donegal
Down
Dublin
Fermanagh
Galway
Kerry
Kildare
Kilkenny
Laois
Leitrim
Limerick
Longford
Louth
Mayo
Meath
Monaghan
Offaly
Roscommon
Sligo
Tipperary
Tyrone
Waterford
Westmeath
Wexford
Wicklow
Please select the county of your school or youth organisation.
Twitter (e.g. @ReelLifeScience)
Leave blank if your school or youth organisation does not use Twitter.
Website or Social Media
Leave blank if your school or youth organisation does not have a website or social media page
SECTION 2: YOUR VIDEO
Tell us about the short science video you've made for ReelLIFE SCIENCE
Competition Theme
*
Please select
Climate Action!
How Things Work
Marvels of Medicine
Myths Busted!
Science and Me
Science Heroes
Science in Space
Science Song
Please select the theme your video best falls under, e.g. is it a video about Science in Space or How Things Work? If it is a musical number, select Science Song or if you are not sure where it fits, just select Science and Me!
Video Title
*
Give your video a good name to differentiate it from others, e.g. 'How Does Photosynthesis Work?' or 'Why Is The Sky Blue?'. It will generally get more views on YouTube too!
Video YouTube Link
*
Please make sure the YouTube link to your video is working and the YouTube video privacy settings are set to 'PUBLIC'. Videos set to 'PRIVATE' or 'UNLISTED' may not be viewable and cannot be considered for the competition. THIS IS REALLY IMPORTANT!
Video Language
*
Please select
English
Irish
Videos can be in English or Irish.
Copyrighted Material Included?
*
No
Please tick 'No' to confirm that copyrighted material (images, music, sound recordings, video clips (e.g. TV, movies, online videos) etc.) has not been used without permission in your video. Please use royalty-free or original music in your video.
Parental Consent received?
*
Yes
Please tick 'Yes' to confirm that all necessary permissions and releases from all persons appearing or identified in the video or any associated photos/still images have been obtained.
Agree to Terms & Conditions?
*
Yes
Click 'Yes' to confirm you have read and agreed to the Terms and Conditions (http://reellifescience.com/teachers-tips/terms-and-conditions/)
SECTION 3: ALMOST THERE
Help us make ReelLIFE SCIENCE even better in the future. Your answers will not affect the outcome of the competition.
How did you first hear about ReelLIFE SCIENCE?
*
Please select
Our school/group participated previously
Poster sent to school
Social Media (Twitter, Facebook, Instagram)
Traditional Media (Newspaper, Magazine)
Other
If 'Other' please specify
i.e. where you first heard about us
TAKING PART IN ReelLIFE SCIENCE...
*
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
...has made me more interested in STEM.
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...has improved my knowledge of STEM.
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...has improved my communication skills.
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...has improved my video production skills.
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Please use this box for any feedback you would like to give us about ReelLIFE SCIENCE.
Your feedback helps us improve ReelLIFE SCIENCE for future participants, so feel free to tell us what you did or didn't like.
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