Signature Program

Signature Program Participation

For schools who do not have an active FAME member, but wish to participate in the Jim Harbin Student Film Festival and support FAME's renowned student-choice reading award programs, Sunshine State Young Readers Award (SSYRA), Sunshine State Young Readers Award Jr. (SSYRA Jr.), and Florida Teens Read (FTR), the Signature Program Participation Fee is the right membership for you. The participation fee helps to offset the costs of running these exemplary programs.

Complete the form below. Upon submitting the form you will be directed to our secure membership payment page. Your membership will not be complete until you submit your payment. Thank you!

signature program participation-$100 (Expires June 30, 2024)

* Indicates required field

Name *

First

Last

Personal Email: This will be your username. PLEASE USE THIS EMAIL ADDRESS AT CHECKOUT. *

Alternate Email *

Phone Number (Home or Cell) Please use this format: 555-555-5555 *

School Name *

School Billing Address *

Line 1

Line 2

City

State

Zip Code

Country

Business Phone Number *

County in which your school is located *

Your FAME region : refer to map on the right *

Your Position *

Do you work at a public, charter, or private school? *

What grade levels does your school service? *

Including the 23-24 school year, how many total years of teaching experience do you have? *

Including the 23-24 school year, how many of your teaching years have you worked as a media specialist? *

What is your race or ethnicity? *

Additional Member 1 *

Position *

Email *

Phone Number *

Additional Member 2 *

Position *

Email *

Phone Number *

Additional Member 3 *

Position *

Email *

Phone Number *

If paying by check, please enter the check number and account holder name. *

Please use ONLY your personal email address during the checkout process! Please DO NOT use bookkeeper's email address.

Submit

Membership year July 1, 2023-June 30, 2024