5014 - Request to show Movies Video

 REQUEST TO SHOW MOVIES/VIDEOS    5014

Date ___________________________________

Name of Teacher____________________________    Class _______________________

Name of Movie/Video _____________________________________Rating ____________

Date to be shown ______________________________________________

Purpose 
____________________________________________________________________________

How does this movie/video relate to instructional objective?
____________________________________________________________________________

___________Approved  

___________Disapproved

Principal __________________________________________    Date _________________

"Please Note" Parents must be notified of the title and date of viewing in advance.

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Piute County School District
500 North Main
Junction, Utah 84740
Phone:435-577-2912 ~ Fax:435-577-2561

 

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