fbla skills events equipment request form

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Secondary Education and CTE
TO:
FBLA Advisors
FROM:
Sandra Parker/Division Director
Office of Student Organizations
DATE:
January 4, 2016
RE:
2016 FBLA State Leadership Conference
STATE CONFERENCE REGISTRATION
The State Leadership Conference (SLC) registration process is online. The online registration link
is located at www.mde.k12.ms.us/fbla. Registration will be closed after March 7, 2016.
The conference will be held Wednesday, Thursday and Friday, April 6-8, 2016, at the Marriott
Hotel in Jackson, Mississippi. A copy of the online completed State Conference Registration Form
and a check made payable to Mississippi FBLA must be postmarked on or before March 7,
2016. Please return this required information to:
FBLA State Advisor
Office of Student Organizations
P. O. Box 771
Jackson, MS 39205
Registration postmarked after the designated date will be denied. Please retain a copy of your
registration form. It will serve as your invoice if needed. You will not be sent an invoice. Your
spelling of each participant’s name on the registration form is how the name will appear on the
name badge. Students will be unable to compete or attend any conference activity without their
name badge attached to their attire.
Requirement: The Office of Student Organizations is requiring that each FBLA Advisor has in
his/her possession a liability form for each student present at the conference. Each advisor will be
required to sign a document on-site verifying that fact. Advisors will not receive their registration
packet until this form is signed. The MDE Liability Form is located at www.mde.k12.ms.us/fbla
- click on Advisor Downloads.
MEMORANDUM #16.041
Central High School Building
359 North West Street
P.O. Box 771
Jackson, MS 39205-0771
Phone (601) 359Fax (601) 359www.mde.k12.ms.us
FBLA Advisors
January 4, 2016
Memorandum #16.041
Page 2
NEW EVENTS AND EVENT CHANGES FOR 2016 (State Conference)
New event: Hospitality Management (test only at state)
Changes to existing events: Publication Design (formerly Desktop Publishing, state only
performance)
Modified Events:
 Business Ethics – removed synopsis requirement
 Future Business Leader - Bring hard copy of resume and cover letter to interview
 Job Interview – removed job application, bring copy of resume and cover letter to
interview. Send 3 copies of resume and cover letter in labeled folders along with
registration to state chapter.
Mississippi will allow top 4 winners to advance to the National Leadership Conference, with only
the top 2 receiving state chapter funds.
A minimum score of 50 will be required for any individual or team to place in any event or project
on the state level.
Event Reminder - Graphing calculators CANNOT be used in Accounting I, Business Math, or
Business Calculations. If a student is found using a graphing calculator while taking the test, the
student will be disqualified on site.
CONFERENCE FEES
All advisors, students, guests, and/or family attending the conference must pay a registration fee
of $30.00, which will cover the cost of the Advisors' Breakfast on the last morning of the
conference. Advisors must register online to attend the breakfast as we will reserve food for
the number registered. No on-site registrations will be accepted. Only advisor(s) should pick
up the chapter registration packet at the conference table. Registration will be open for conference
packet pick-up from 2:00 p.m.- 4:00 p.m. on Wednesday and Thursday from 8:00 a.m. – 9:45 a.m.
PARKING FOR CONFERENCE
Complimentary parking is available for schools staying at the Marriott. If a hotel parking fee is
charged on your bill, please visit the hotel desk. For schools not staying at the Marriott, the
parking fee will be $8.00 per day. The maximum height clearance for vehicles parking in the
parking garage is 6 ft. 5 inches. Because we realize that bus parking is a problem at the Marriott
Hotel, we have made arrangements with the city to block off parking spaces on the streets (Lamar
and West Streets) for buses and vans. These spaces will be covered with bags. There is a $60.00
flat rate fee to park your bus or van (mini or full size) on the street at any time during the
conference. If you are traveling by bus, you must complete the invoice enclosed and mail the form
along with your registration form. On the day of the conference Bus Parking Passes must be
picked up at the registration table when you pick up your packets.
FBLA Advisors
January 4, 2016
Memorandum #16.041
Page 3
The Bus Parking Pass must be placed in the window of your bus or van so that the city police will
not write you a ticket. If you park in a space with an uncovered meter, you will be responsible for
the parking ticket or towing if applicable.
CHAPERONES
It is highly recommended that chapters have one (1) advisor/chaperone per ten (10) students. This
recommendation is for your safety as well as the safety and well-being of your students.
RECOGNITION
At the State Leadership Conference the Membership Madness Award will be given to all FBLA
members who recruit 5 or more members. You will find an attached form to complete to assure
that your students receive recognition. Chapters that have increased their membership by 10%
from the previous year will also be recognized. Advisors, please submit verification to the State
FBLA President.
GENERAL INFORMATION
Copy and discuss with your students the "Conference Section" in your Revised Mississippi FBLA
Guidelines found online at www.mde.k12.ms.us/fbla.
RETIRING ADVISORS
If you or someone you know is retiring, please email me the advisor's name, school name, and the
number of years of service to FBLA so that they can be recognized at the Advisors’ Breakfast.
The postmarked deadline is Friday, March 7, 2016.
ATTIRE
The wearing of appropriate professional attire is expected of all students and advisors who attend
the general sessions. If you or your students are not dressed properly, permission to attend the
general sessions or the competitive events could be denied. An opportunity to change and then
return will be given. The rule of judgment is to ask, "Would I or my student be dressed properly
to attend a Job Interview?" Review the FBLA Dress Code with your students which can be
found on the FBLA National website. Our office is committed to seeing that the Dress Code
is followed. Avoid embarrassment for yourself or your student(s) by coming to the
conference dressed appropriately. Adult monitors will be present to be certain the FBLA
dress code is followed.
RESERVATIONS
You can call the Marriott Hotel (601.969.5100 or 1.800.marriott) for reservations, or go online at
www.marriott.com/janmc. When calling, please use the code: fblfbla. Your phone reservation
must be followed up with a faxed or mailed hotel housing form with your confirmation
numbers attached! For documentation, keep a copy of your successful fax notice. A contracted
flat rate of $112.00 (plus applicable state and local taxes - currently 11%.) This rate is per night
for up to 4 persons per room. For tax exemption, you must present proper documentation. Please
make plans to stay in the host hotel as it reduces the costs to FBLA members to rent space for our
competitions. Check-in time is 3:00 p.m. and checkout is 12:00 noon.
FBLA Advisors
January 4, 2016
Memorandum #16.041
Page 4
MARRIOTT HOTEL
Please review hotel etiquette with your students, for example: allow persons to exit the elevator
before entering, no door slamming or yelling in hotel hallways, etc. If students use room service,
a 20% tip will automatically be added to the bill.
RESERVED SEATS
For all general sessions, several rows of front seats will be reserved for the conference guests, not
students. No school chapter will be allowed to save seats. Seats are available on a firstcome/first-serve basis. This rule applies to everyone!
OBSERVE CLOSELY THE STATE CONFERENCE PROGRAM FORMAT
Several events will be offered on Wednesday afternoon, April 8 this year. The events are:
Business Ethics, Emerging Business Issues, Business Presentation, Global Business, Publication
Design, Computer Applications (one-hour written test), and Sports and Entertainment
Management. The skills portion of Computer Applications will be given the following day at Hinds
Community College/Jackson Campus - 3925 Sunset Drive - Jackson, MS - 39213. Chapters are
responsible for their student’s transportation to Hinds.
Some additional changes have been made to the event locations and timeframes this year;
therefore, you will need to look closely for the correct times and locations of your events. Due to
an early printing schedule, additional changes may have to be made between now and the time of
the conference. (A copy of the tentative program (subject to change) can be found on the
MDE/FBLA website after April 1). All events (except the skills portion of Computer Applications
and Word Processing) will take place at the Marriott Hotel.
MANDATORY MEETING
At the conclusion of the State Leadership Conference, it is mandatory that each individual or
team winner’s advisor who placed in a first, second or third place position of an event attend a
meeting concerning the National Leadership Conference (NLC). If there is a legitimate reason
(illness or death) that the Chapter Advisor cannot attend this mandatory meeting, then it is the
advisor’s responsibility to contact me within 2 days following the SLC to obtain the essential
form that is necessary to complete. This form must be completed whether you plan to attend the
NLC or if you do not plan to attend. You must notify the State Chapter of your intentions. If the
NLC intent form is not completed and received by the deadline date indicated on the form, a
substitute will be contacted and placed in that position. In addition, no state chapter funds
will be given to that winner. Please refer to the back of your State Conference Program for the
events showing asterisks as to what placements are eligible for competing at NLC. You must
attend this meeting if you are considering attendance at NLC.
FBLA Advisors
January 4, 2016
Memorandum #16.041
Page 5
STATE ONLY COMPETITIVE EVENTS
If you have students who did not place at the district level, the state chapter offers “state only”
competitions at the State Conference. Consult your Mississippi Guidelines for a listing of these
events.
OFFICER CANDIDATE ORIENTATION
Candidates and their advisors are required to attend an orientation session Thursday of the
conference at 8:30 a. m. Please make arrangements to attend this very important meeting.
2017 MIDDLE LEVEL FBLA STATE CONFERENCE (6-8th grade)
Florence Middle School, Florence, MS will be the location for the FIRST Middle Level State
Conference. Stay tuned for more information as the time approaches!
NO COMPETITIONS AT 2016 STATE CONFERENCE FOR GRADES 6, 7 AND 8
As stated in the Mississippi Competitive Events Guidelines, page 4, no competitive events are
offered for middle level students at the state conference. No 6th, 7th or 8th graders are allowed to
attend. National FBLA does not offer middle level competitive events except for open events.
PARLIAMENTARY PROCEDURE, ENTREPRENEURSHIP, AND BANKING AND
FINANCIAL SYSTEMS
Teams cannot substitute members after district conference. Teams scoring in the top 6 on the
written one-hour test will be picked at random by the coordinators for the performance portion of
the event at the state conference.
INTRODUCTION TO BUSINESS MATH AND BUSINESS CALCULATONS
Students must bring their own non-graphing calculators to use for these events. National
guidelines states that non-graphing calculators are the only type of calculators to be used during
the test. Test coordinators will NOT allow any other type of calculator in the testing room. If a
student is seen using any other kind, they will be disqualified.
EMERGING BUSINESS ISSUES, WEBSITE DESIGN, AND INTRODUCTION TO
BUSINESS PRESENTATION
Please read carefully the rating sheets and competitive event information. There have been some
changes in these events. Several events require a Statement of Assurance form.
ELECTRONIC CAREER PORTFOLIO Please check and double check the URL address to
make sure that it is workable. To assure that the judges can view, you may want to enclose a jump
drive.
INTERVIEW AND PERFORMANCES
Conference attendees will not be allowed to observe the performance of the following events:
Parliamentary Procedure, Impromptu Speaking, Public Speaking I and II, and Entrepreneurship.
All interview and performance event times will be posted outside of the SLC headquarters at the
hotel.
FBLA Advisors
January 4, 2016
Memorandum #16.041
Page 6
JOB INTERVIEW - Please read the instructions in the Chapter Management Handbook carefully.
Three copies of the resume and cover should be mailed to:
Dr. Diane Fisher
USM, 118 College Dr. #5023
Hattiesburg, MS 39406-000
FUTURE BUSINESS LEADER
Please mail your Future Business Leaders resumes by the postmarked deadline date of March
7, 2016. Mail to:
Myra Pannell
Research and Curriculum Unit
Mississippi State University
PO Drawer DX
Mississippi State, MS 39762
The state chapter is not responsible for resumes submitted otherwise.
STATE CONFERENCE ENTERTAINMENT
The March of Dimes entertainment is always a highlight for our students at the SLC. This function
is being held to raise funds for the March of Dimes. An entrance fee of $2.00 or more is advised.
The entertainment theme this year is “Pajama Movie Night”. Students can wear casual pajamas
(long pants for girls and boys). Refreshments such as popcorn, soft drinks and candy will be
available for purchase to fund the March of Dimes. Please advise your members to dress modestly!
WRITTEN AND STATE PROJECTS
Submit 3 hard copies for all of these events for SLC. American Enterprise, Community Service,
Local Chapter Annual Business Report, Business Plan, Business Financial Plan, Digital Video
Production, Electronic Career Portfolio, and Website Design projects postmarked by the March
7, 2016 to the state chapter. No oral delivery presentation will be required at the state conference
for any of these events. On the National level, first, second, third and fourth place state winners
in these events will be required to present an oral report. Note: In the Business Plan Event, only
the top ten (10) written report national winners. Review the national guidelines for complete
information. Projects will be submitted electronically online for national competition.
BUSINESS PERSON OF THE YEAR
This event recognizes outstanding business persons from the private sector who have contributed
to the success of FBLA. Each chapter may nominate one person. If the person will be attending
the state conference, please note on the resume of the business person that he or she will be
attending the SLC; otherwise, the state office will assume your representative is unable to attend.
Please follow your guidelines carefully when putting your nomination materials together. In
addition to a formal resume, a one-page summary is required. The summary should include the
nominee’s FBLA-PBL participation, promotion, and contributions to your local chapter. The
postmarked date for the nominations is March 7, 2016.
FBLA Advisors
January 4, 2016
Memorandum #16.041
Page 7
SKILLS EVENTS EQUIPMENT REQUEST FORM - The local advisors of district winners in
Computer Applications and Word Processing must notify Hinds Community College, Jackson
Campus, of equipment and software needs. Contestants may use existing equipment and software
at the Jackson Campus, or contestants may take their own. The attached form must be returned to
Jackie Waite by the postmarked deadline of March 7, 2016. If you have questions concerning
equipment and software, please direct them to Jackie Waite at 601.987.8120.
The State Chapter will NOT provide transportation to Hinds Community College, Jackson
Campus. The local chapter is responsible for getting the competitor to the community
college.
PARTNERSHIP WITH BUSINESS PROJECT
Please review the guidelines in the National Management Handbook. This event is neither a
Mississippi district nor state event. If a chapter is interested in competing in the event at the NLC,
the project is due in the state office by May 1. Only the top three reports will be submitted to the
National Office in May. If a Mississippi Chapter is among the top ten finalists nationally, the
chapter will be notified by the National Office prior to June 2. All finalists must give oral
presentations at the NLC.
EVENT COORDINATORS
Advisors are needed as event coordinators for the state conference. At each district conference
Advisors' Meeting, advisors will be asked to assist with state conference competitive events.
Please take this job seriously. Coordinators will not be able to pick up the facilitator packet and
tests (hard copies) until 15 minutes prior to the event. Come to FBLA headquarters to get your
materials. Your cooperation and helpfulness is appreciated.
SLC AGENDA (TENTATIVE)
On or before April 1, 2016, you will be able to download from the Mississippi FBLA website a
copy of the tentative agenda for the State Leadership Conference. Please pay close attention to
times and locations of your students’ test. The online copy is tentative and subject to change.
VITAL INFORMATION FOR YOU AND YOUR STUDENTS –
 Cell phones, pagers, or any audio or video recording device(s) are not allowed in the
testing rooms or holding rooms. If these items are seen or observed by a test facilitator,
the competitor will be dismissed from the testing room and disqualified from the
competition. Pencils will not be provided to students for taking the scantron tests.
FBLA SCHLOLARSHIPS – Mail the Jan Guyse Scholarship and the Harold Harris
Scholarship applications to the State Office by the postmarked date of March 7, 2016.
The Rufus T. Jones Scholarship application is to be mailed to Lisa Courtney, 1109 Ray Ave.,
Wiggins, MS 39577 by the postmarked date of March 7, 2016.
FBLA Advisors
January 4, 2016
Memorandum #16.041
Page 8
IN CONCLUSION
We know each of you will give your best efforts to the conference, which represents the ideals,
goals, and objectives of your entire chapter. Every year is extremely important to you, your
members and the progress and growth of FBLA/PBL as an organization. We realize that no
conference will be perfect, but your suggestions and assistance are needed in order to make
improvements to next year's conference. Please put your suggestions in writing and email them to
me at ssparker@mde.k12.ms.us. There is a student and advisor evaluation form located on the
MDE/FBLA website for your convenience. Thank you for your support of FBLA.
Please copy and share this memo with your principal or your CTC director and place this memo
in your memo notebook.
DOCUMENTS TO REMEMBER
(Postmarked deadline date is on or before: March 7, 2016)
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Business person of the Year Resume and One-Page Summary (mail to State Chapter)
Membership Madness information to Brianna Ladnier, FBLA President, St. Martin High
Schoo1, 11300 Yellow Jacket Blvd., Ocean Spring, MS 39564
Local Recruitment of 10% Chapter Membership Increase letter to: Brianna Ladnier, FBLA
President, St. Martin High Schoo1, 11300 Yellow Jacket Blvd., Ocean Spring, MS 39564
Copy of SLC Registration form (downloaded from the online registration). Mail with
attached fees to the State Chapter (P. O. Box 771, Jackson, MS 39205.)
Who's Who in FBLA- Mail to State FBLA Chapter- (Application in Mississippi FBLA
Guidelines)
Skills Event Equipment Request Form (Send to Jackie Waite at Hinds CC/Jackson Campus
– 3925 Sunset Drive – Jackson, MS - 39213)
March of Dimes (MOD) Contributions - (send to March of Dimes, 1991 Lakeland Dr.,
Suite G, Flowood, MS 39261. Be sure to attach the required form along with your check).
When the MOD office receives your check you will receive an email. If you do not receive
an email, please contact the MOD office.
Local Chapter Annual Business Report (3 hard copies to the state chapter)
Business Plan Project (3 hard copies to the state chapter)
Business Financial Plan Project (3 hard copies to the state chapter)
American Enterprise Project (3 hard copies to the state chapter)
Community Service Project (3 hard copies to the state chapter)
Jan Guyse Scholarship application, (located in the State Guidelines on the web.) Mail to
the state chapter.
Harold Harris Scholarship Application (located in the State Guidelines on the web). Mail
to the State Chapter.
Rufus T. Jones Scholarship Application (located in State Guidelines on website, mail to
Lisa Courtney, 1109 Ray Ave., Wiggins, MS 39577 by the postmarked date of March 7,
2016.
FBLA Advisors
January 4, 2016
Memorandum #16.041
Page 9
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Digital Video Production (UBS or DVD, clearly labeled) with State of Assurance form
(mail to state chapter)
Electronic Career Portfolio Event – DVD, USB or accessing it via the Internet. (state
chapter)
Website Design Event available for viewing via the website. Submit with URL on State
of Assurance form. (state chapter)
Computer Game Simulation & Programming – Submit CD/DVD/USB along with
statement of Assurance (state chapter)
Public Service Announcement – Submit scrip, Statement of Assurance and video on due
date. (state chapter)
Publication Design should NOT be mailed. The presentation will be delivered to the
judges using hard copies they bring with them.
Attachments: Bus Parking Reservation Form
FBLA Skills Event Equipment Request Form
Marriott Hotel Reservation Form
Chapter Membership Increase and Membership Madness Form
Statement of Assurance Form
c:
Lisa Courtney
Angela Kitchens
Mike Mulvihill
Jean Massey
PARKING RESERVATION FORM
FBLA STATE CONFERENCE
The maximum height clearance for vehicles parking in the parking garage is 6 ft. 5 inches.
Because we realize that parking is a problem at the Marriott Hotel, we have made
arrangements with the city to block off parking spaces on the streets (Lamar and West
Streets) for buses and vans. These spaces will be covered with bags. There is a $60.00 fee
for parking your bus or van (mini or full size) on the street at any time during the conference.
If you are bringing a bus, you must complete the invoice and mail the form along with your
registration form. On the day of the conference Bus Parking Passes must be picked up at the
registration table when you pick up your packets. The Bus Parking Pass must be placed in
the window of your bus or van so that the city police will not write you a ticket.
If you have questions, please contact the Office of Student Organizations at 601-359.2387.
PARKING INVOICE
BUS OR VAN
NAME OF SCHOOL:_____________________________________________________
ADDRESS:______________________________________________________________
ADVISOR:______________________________________________________________
Contact phone # while on-site____________________School phone________________
Email Address:___________________________________________________________
Flat fate of $60 for parking a bus on the street at any time during the conference.
TOTAL AMOUNT ENCLOSED $____________
FBLA SKILLS EVENTS EQUIPMENT REQUEST FORM
(A form must be completed for each student competitor)
Student’s Name: ______________________________________________
(Please Print)
EVENT:________________________________________________________________
School: _________________________________________________________________
Advisor:____________________________________ School Phone: _______________
E-mail address___________________________________________________________
_____Using Hinds Community College equipment
_____Bringing own equipment (includes power cords, printer, mouse, etc.)
The skill events will be at Hinds Community College, Jackson Campus, in the Bivins
Building. Please check the FBLA Conference Program for the time of the events. Hinds
have 4 networked labs with one printer in each lab. Each lab has Office 2010 Professional
(Word, Access, Excel, PowerPoint, and Publisher).
_____ EVENT: Computer Applications (2 hours)
_______ EVENT: Word Processing
(1 hour)
Please return this equipment request form by March 6, 2015 to:
Jackie Waite
Hinds Community College, Jackson Campus
3925 Sunset Drive
Jackson, MS 39213
Phone 601-987-8122; fax 601-982-5804
e-mail : jwaite@hindscc.edu
MISSISSIPPI FBLA – STATE LEADERSHIP CONFERENCE – MARRIOTT
ROOMING LIST
April 6-8, 2016
FAX LIST TO GLORIA COOLEY AT 601.353.4333 OR E-MAIL TO gcooley@columbiasussex.com
.
MAIL LIST WITH PAYMENT TO: Marriott/Jackson - 200 East Amite Street - Jackson, MS – 39201 – Attention Gloria Cooley
School:
Contact Advisor:
Email Address:
Phone #:
School Address:
City/Zip:
Arrival Date:
Departure Date:
Arrival Time:
Mark payment type.
Number of Buses or Vans:
Check
Credit Card#:
Ex. date:
*Room rate $112.00 per night + 11% tax for Single, Double, Triple, or Quad
Please indicate the names of the persons who will be occupying/sharing each room being reserved:
[REPRODUCE IF MORE ROOMS ARE NEEDED.]
Male/Female
Male/Female
1.
Male/Female
Male/Female
1.
1.
1.
2.
2.
2.
2.
3.
3.
3.
3.
4.
4.
4.
4.
Conf. #
Conf. #
Conf. #
Conf. #
Male/Female
Male/Female
1.
Male/Female
Male/Female
1.
1.
1.
2.
2.
2.
2.
3.
3.
3.
3.
4.
4.
4.
4.
Conf. #
Conf. #
Conf. #
Conf. #
Room Rate
Total per Room
(11% tax added)
$112.00
$124.32
X # of Rooms
Total Amount Due
*A TAX EXEMPT CERTIFICATE MUST BE ATTACHED TO THE CHECK IN ORDER TO RECEIVE EXEMPTION STATUS.
MAKE CHECKS PAYABLE TO: MARRIOTT JACKSON
PAYMENT AND ROOMING LIST REQUIRED 2 WEEKS PRIOR TO APRIL 6, 2016.
NO CANCELLATIONS WITHIN 24 HOURS PRIOR TO APRIL 6, 2016.
This room block will be held until March 15, 2016
Chapter Membership Increase and Membership Madness Form
Awards are given to the local chapters that increase their membership by 10% or more during the
school year. Please provide the following information and return the top portion of this form to:

Brianna Ladnier, FBLA President, St. Martin High School, 11300 Yellow Jacket
Blvd, Ocean Springs, MS 39564
Name__________________________________________________
Advisor’s Name________________________________________________
Last year’s membership
__________________
This year’s membership
__________________
Total percentage increase
__________________
------------------------------------------------------------------------------------------------------------
Membership Madness Award
Membership Madness awards are given to students who recruit 5 or more NEW members.
Please complete the bottom information below and mail to:

Brianna Ladnier, FBLA President, St. Martin High School, 11300 Yellow Jacket
Blvd, Ocean Springs, MS 39564
Student’s Name
_____________________________________________
School Name
_____________________________________________
Advisor’s Name
_____________________________________________
Attach a copy of the membership roster circling the new member’s names.
STATEMENT OF ASSURANCE – EVENT ENTRY FORM
Circle one:
Digital Video Production
Web Site Design
Computer Game Simulation & Programming
Public Service Announcement
For Web Site Development give the URL. These events will be judged online. Make sure the
URL link is workable for state and the National Leadership Conference judging.
Chapter: ________________________________________________________________
School: _________________________________________________________________
Web site URL Address: ____________________________________________________
(where appropriate)
Member(s) Name:
________________________________________________________________________
Local Chapters Contact (advisor preferred)
Name: _________________________________________________________________
Daytime Phone Number: ___________________________________________________
Mailing Address: ________________________________________________________
________________________________________________________
________________________________________________________
Home E-mail:
________________________________________________________
I/We, the understand attest that the design, creation, and implementation of the event are the
original work of the above chapter member(s). I/we agree that this event may be linked,
promoted, and used in any way by the national FBLA-PBL, Inc. for purpose of promoting the
association. (Typed name is accepted for signature)
Name of Team Member
_______________________________
Advisor’s Name
_____________________________
Name of Team Member
________________________________
Name of Team Member
______________________________
Attach this form with (1) copy of the materials for Digital Video Production, Website Design,
Computer Game Simulation and Public Service Announcement.
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