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CACTUS TRAILS ELEMENTARY SCHOOL

Movie Viewing Request

Teacher Name: ____________________________________ Grade: _____________


Date of Movie Showing: ____________________________
Title Of Movie: ____________________________________ Rating: ____________
TEKS:________________________________________________________________________________________
______________________________________________________________________________________________
Purpose for movie:
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________

Teachers Signature: _______________________________________ Date: __________________


Approved Denied
Principal’s Signature: _____________________________________ Date: ___________________

CACTUS TRAILS ELEMENTARY SCHOOL


Movie Viewing Request

Teacher Name: ____________________________________ Grade: _____________


Date of Movie Showing: ____________________________
Title Of Movie: ____________________________________ Rating: ____________
TEKS:________________________________________________________________________________________
______________________________________________________________________________________________
Purpose for movie:
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________

Teachers Signature: _______________________________________ Date: __________________


Approved Denied
Principal’s Signature: _____________________________________ Date: ___________________

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