CALL FOR PRESENTATIONS for PBIS Institute
FILM FESTIVAL SUBMISSION
Please return this form by June 15, 2017
Annual Minnesota PBIS Institute:
June 20 -21, 2017
Minnesota Department of Education - Roseville, MN
The Minnesota School-Wide Positive Behavioral Interventions and Supports (PBIS) Team is pleased to announce:
The Annual PBIS Institute is seeking film submissions for the 2017 Film Festival. Please note that if you are submitting more than one film a separate entry form must be completed for each.
For VIDEO SUBMISSION for the Film Festival:
Video Title:
Short Description of Video (50 words):
Upload your video to the internet (e.g., Vimeo, YouTube, Teacher Tube) and provide the URL for the posted video
Video URL:
This completed form must be submitted by June 14, 2017 to: with the subject of Video Entry.
Any questions regarding this proposal or submission should also be submitted to with the subject line 2017 PBIS Institute Question.
MINNESOTA PBIS FILM FESTIVAL ENTRY FORM
Dear PBIS Film Festival Entrant:
The Annual Minnesota PBIS Film Festival will be held on during the 2016 Minnesota PBIS Institute. The purpose of the film festival is to highlight and compile a sampling of PBIS videos created by Minnesota teams. There will be a light-hearted competition to acknowledge videos in a variety of categories. You are cordially invited to submit your school video(s) to be featured during the festival. Please limit video submission for competition to 2 videos per school and 3 minutes in length; see submission instructions below for additional information. Videos must be submitted by June 14, 2017. Schools that would like to submit a video but cannot attend the conference are still encouraged to submit. Videos should have a direct connection to your PBIS efforts and the selection committee will determine winning categories (Funniest, Use of Data, Introduction to PBIS, Establishing Buy-In, Staff-Orientated, Student-Orientated, Teaching Expectations, etc.).
Please note: It is assumed that videos produced at the local school level were done in accordance with district guidelines for video/media production—especially when students are involved.
In order for your school to submit videos for the film festival you must:
1- Have a school or district administrator sign the authorization for permission below.
2- Write the following message on your district letter head and sign the document.
- “I, the undersigned, have secured local permission from the student(s), teacher(s) and administrator(s) involved in the production of the submitted video(s) and have the authority to submit the videos to the Film Festival.
- The statement on letterhead must be included along with this completed form.
3- Email the letterhead statement and the consent form below to with the subject of Video Entry
4- If your video is longer than 3 minutes please specify the 3 consecutive minutes in your video that you are submitting for competition
I am authorized to give permission, and do so, for the entry of my school’s PBIS video in "The Fourth Annual PBIS Film Festival".
Date
Name
Your Official Position
Phone Email
Signature (Electronic will suffice)