STN Affiliate Registration Form


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Registration or renewal completed after March 2nd, 2021 will be valid through October 1st, 2022
Please fill out the following information as completely and accurately as possible...

Your Information

Your Name:
Your Email:
Please enter a password below. You will use your email address and this password to access the STN Dashboard to register for seasonal contests and the Convention, upload videos for competitions, and view judging results.
Dashboard Password:
Confirm Password:
Shipping Address:
Shipping City:
Shipping State:
Shipping Postal Code:
Cell Phone:
          
Want to load up the existing information that we have on file?
Email:   Password:  

Membership Information

Membership:

Registration Type:
How did you hear about STN:
Referral Code:
If STN Associate, please complete the following:
Previously Associated School:
Current Relationship to School:
Donate to the STN Scholarship Fund:  $
The STN Scholarship Fund makes funds available for students and teachers to attend events and training sessions.
Add a Co-Teacher Login:
– Co-Teacher Full Name:
– Email / Dashboard Login:
– Dashboard Password:
– Phone / Mobile Number:

School Information

School Name:
Type of School:
School Level:
Total Campus Population:
Billing Address:
Billing City:
Billing State:
Billing Postal Code:
Payables Dept. Contact Name:
Payables Dept. Phone:
Payables Dept. E-Mail:
Student Demographics   (please complete all - estimates are OK)
Free/Reduced Lunch Population % Hispanic %
African American % White %
American Indian % Asian %
Pacific Islander % Two or More Races %

Affiliate / Program Information

Affiliate/Program Name:
Affiliate/Program Website:
Program's Primary Focus:
Number of Students in Program:
Years Teaching Current Program:
Total Years Teaching:
Primary Editing Software:
– Other Software:
Currently Run Advertising?:
Estimated Monthly Views:
Do you host a Podcast:
– Podcast Title:
Primary Broadcast Methods   (check all that apply)
YouTube:
Vimeo:
Wistia:
Twitch:
Other:
Facebook:
Instagram:
Twitter:
SnapChat:
TikTok:
 
MEMBERSHIP PREFERENCES
Would you like to be a part of our online community of Affiliates:
Would you like to receive information from our Partners / Vendors:
Are you NEW to STN and would like to be in our mentorship program:
Are you a VETERAN teacher and like to mentor a new STN Teacher: