PANASONIC KID WITNESS NEWS CANADA – ENROLLMENT APPLICATION
 
 
If you are interested in forming a Kid Witness News team at your school, please complete and submit the following application form:
 
 
Name of school:
 
 
Address 1:
 
Address 2:
 
City:
Province:
Postal Code:
 
Contact Name:

 
Email Address:
 
 
 
Title:
Telephone:
 
Background information on your school and your interest in the KWN program
 
How the program would benefit your school
 
Indicate the name and contact information of the teacher who would be assigned as the designated coordinator, if different than contact listed above
 
Provide school website address:
 
Students in grades 5-12 (age 18 and under) are eligible for participation. We cannot guarantee the number of openings in a given year. All information collected will be kept in confidence in accordance with our Privacy Policy.
 
 
I have approval from the School Principal or School Board Superintendent to participate in KWN
 
Name of Principal or School Board Superintendent:
Title:
 
 
By filling out and submitting this form, I am providing my consent to Panasonic Canada Inc. to collect my personal information for KWN purposes. I understand that I can withdraw my application at any time.