Self and society in virtual contexts/Photo release

Photo Release
I ,(please print) __________________________________________, give Rutgers permission to record my image and/or voice and grant Rutgers all rights to use these recordings or photographs in any medium for educational, promotional, advertising, or other purposes that support the mission of the university. Signature ________________________________________________________ Date  _______________  Address   _____________________________________________________________________________    Phone number  ________________________________________________________________________  Email  _______________________________________________________________________________  Notes  _______________________________________________________________________________    ____________________________________________________________________________________      ____________________________________________________________________________________    _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 UNIVERSITY STUDENT/ALUMNUS Please complete if the person in the recording is a Rutgers student or alumnus College _________________________ Major   __________________________ Class   ______________   _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ F



OR DEPARTMENTAL USE Project number  _________________________ Project name  __________________________________ Project manager  _________________________ Photographer/Videographer   ______________________ Location  ____________________________________________ Gender: Male  _______   Female  ______  Hair color/style   _________________________ Glasses   _____ Jewelry   _________________________  Shirt color/style  _________________________ Pants color/style   _______________________________  General model description  _______________________________________________________________    ____________________________________________________________________________________      ____________________________________________________________________________________