College of Agricultural, Human, and Natural Resource Sciences

Current and Future Students

Photo and News Release Form: Faculty, Staff or Team

This form must accompany all entries for 2007 College of Agricultural, Human, and Natural Sciences Awards or Displays.

Please complete the form below, then print it; include a copy of the printed form with your award/display application(s).

Please answer questions accurately. The information will be used to promote you, your team, and/or the awards/dispalys.

Please type or print clearly (use black or blue ink).

Please direct questions to Linda Bentley.

Date

I am:
female
male
a member of a team

Full name of person or team:

If a group, list all members of team:

My nomination is for:

Briefly list outstanding accomplishments:

Work Address (please include county):

Names of local and weekly newspaper(s)including towns or cities (we'll use this information to help promote you, your team, and the awards):

By submitting this form, I grant permission to Washington State University (WSU) to publish my/my team's story and/or picture for use in promotional, educational, display or other media publications including newspapers, magazines, television, brochures, pamphets, instructional material, books, web pages and/or other educational material.

For team applications, that this signed agreement applies to all group members. I understand that electronically completing this form by typing my name below constitutes a signature. If completed manually, I will sign the form for myself and group members, using black or blue ink.

My signature:

Please print this page and include with award/display application(s).

 

 

CAHNRS, Hulbert 421, PO Box 646242, Washington State University, Pullman WA 99164-6242, 509-335-4562, Contact Academic Programs