GIFT Teen Panel Registration

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High School Students Taking Part In Group Discussion

Teen Panel

How did you hear about the Global Innovation Field Trip Teen Panels?(Required)

Full Name of Person Completing Form:(Required)

(Person completing this form must be 18 years old or older.)

Person Completing Form Is:(Required)

Parent/Guardian

Teacher

Program Leader

Student Participant who is 18 years old or older

Email Address of Person Completing Form(Required)

Enter Email Confirm Email

Phone Number of Person Completing Form(Required)

Time Zone (of person completing this form)(Required)

Student Participant Full Name(Required)

Country(Required)

State, Province, Territory, Prefecture, Republic or Region(Required)

Age of Participant(Required)

Email Address of Participant (Parent's if under 18)(Required)

Enter Email Confirm Email

Describe your current school situation:

Attend in person daily

Attend distance learning daily daily

Hybrid of in-person and distance learning

Homeschooled

Other

Paste a link to a short cell video explaining who you are, why you should be selected and what you think might be a good topic for the panel to discuss.(Required)

(Video must be created through YouTube or Bilibili and should be saved as “Unlisted” or “Public.” Do not save as “Private.”)

Upload Image(Required)

Max. file size: 512 MB.

(Image may be used in social media and for promotion of this and other Teen Panels and promotable topics or events. Approved formats as a PNG, JPEG or PDF.)

By completing this registration and/or participating in this event, you agree to the following Photographs and Media CONSENT:(Required)

I agree to the privacy policy.

Consent Form

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