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<<< 2024 Be Tick Free Media Contest


"Be Tick Free!"
Dutchess County's 2024 Media Contest Submission Form

ALL Participants (Individuals and Group Members) Must Submit this Form
on or before 11:59pm May 1

2023 Contest Winners

* = Required



Public Service Announcement Video Requirements (Check Yes to indicate All requirements have been met.)*


Select Entry Type: *

If Group, include the names and grades of each member: Maximum number of characters: 2,000

VIDEO YouTube URL: *

Name (First, Last): *

Grade: *



Street Address: *

City/Town/Village: *

State: *

Zip Code: *

School / Organization: *

Adult (21 years & older)/Org. Leader Name: *

Adult/Org. Leader Phone: *

Email: *


How did the student(s) hear about the Be Tick Free! Media Contest? *
Maximum number of characters: 2,000

Parent/Guardian Contact Information


Parent/Guardian Name: *

Phone Number: *

Email:

Work Phone Number:



We verify the video submitted for consideration is the above mentioned student’s/group’s original creation for Dutchess County Department of Behavioral & Community Health’s 2023 “Be Tick Free!” Media Contest; and by submitting this video, we understand it may be displayed, reproduced, and promoted as part of the “Be Tick Free!” campaign and educational materials. All entries become the property of the Dutchess County Department of Behavioral & Community Health’s “Be Tick Free!” Campaign.



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