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bossi er parish communitLt college FOR MEDIA/MODELING/PERFORMING/NARRATION/ARTWORK FORM (Bossier Parish Community College)

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bossi
er
parish
communitLt
college
EMBRACING
•
EDUCATING
•
EMPOWERING
FOR
OFFICE
USE
ONLY:
Ev
e
nt
RELEASE
FORM
FOR
MEDIA/MODELING/PERFORMING/NARRATION/ARTWORK
College
publications/video/photography/online
platforms/
and
all
other
communications
I,
___________
hereby
consent
that
all
photographs,
video
taken
of
me,
recordings
made
of
my
voice,
or
artwork
created
by
me
may
be
used
by
Bossier
Parish
Community
College
staff
(or
its
designee)
and/or
others
with
its
consent,
for
the
purpose
of
illustration,
advertising,
or
publication
in
any
manner.
Participant's
Signature
______________________
_
Email:
______________
Phone:
__________
_
Address:
_________________________
_
City:.
______________
State:
__
_
Zip:
______
_
FOR
BUSINESS
RELEASE:
Name
of
Business
_______________________
_
Address:
--------------------------
City:
.
______________
State:
__
_
Zip:
______
_
Phone:
_____________
Email:
___________
_
Person
authorizing
BPCC
to
use
business
in
College
communications
Na
me
Titl
e
Date
(5
/7/
2014
)
click to sign
signature
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bossi er parish communitLt college FOR MEDIAMODELINGPERFORMINGNARRATIONARTWORK FORM (Bossier Parish Community College)

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Completed 26 July 2020

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