Email
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Name
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First Name
Last Name
What industry sector do you work in, or what is your area of expertise?
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Agriculture and Natural Resources
Arts, Media, and Entertainment
Building and Construction Trades
Business and Finance
Education, Child Development, and Family Services
Energy, Environment, and Utilities
Engineering and Architecture
Fashion and Interior Design
Health Science and Medical Technology
Hospitality, Tourism, and Recreation
Information and Communication Technologies
Manufacturing and Product Development
Marketing Sales and Service
Public Services
Transportation
Other
What is your profession/career?
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BlackFemaleProject uplifts the voices of Black female professionals, affirms their experiences, and offers insights for achieving self-defined success in the workplace and beyond. Why do you believe in the mission of BlackFemaleProject?
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What brought you to BlackFemaleProject?
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How has BlackFemaleProject impacted you personally?
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What’s your favorite offering or moment from BlackFemaleProject?
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What has inspired your donation or membership to BlackFemaleProject?
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How has your donation come back to you in any unexpected ways?
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Brief Bio
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Please include a bio (250 word max). If you have a pre-existing bio that you'd like us to pull from the internet, please share the link. (If you provide a longer bio, we may revise to meet with the word limit.)
Share a link to your HIGH RES portrait/headshot.
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Share your social media handles and websites. (If you don't have any, please answer none.)
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MAILING ADDRESS
(We like to send cards sometimes :))
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
This document is a release (the “Release”), in which you grant Black Female Project, Inc., a nonprofit public benefit corporation incorporated under the laws of the State of California, d/b/a BlackFemaleProject (“we” or “us”) the right and permission to use (i) your name, image, and likeness, (ii) any videotapes, photographs, and/or recordings of you, and (iii) any biographical information you provide to us in any medium, including any such information you previously provided or in the future provide to us (the foregoing items (i) – (iii) collectively, your “Likeness”). We are asking for this permission today in connection with your participation in a story-collection project titled “Teacher Truth.” However, we engage in a wide range of promotional activities, both internally and externally—including, for example, maintaining a website and participating in certain social media. Sometimes we engage third party vendors to assist with those efforts. We do not know right now how those efforts will evolve over time, and it would be extremely difficult to revisit this issue every time a new promotional initiative is launched or technology adopted. Accordingly, we are asking for your permission to use your Likeness generally, not just in connection with the purpose described above. By signing below, you agree to the following: 1. You give us your consent to record and use your Likeness. a. Permission to film, photograph, and record. You grant to us, and to those acting for us with our authority and permission, the absolute right and permission to film, photograph, and record (in any medium) your Likeness, including the right to use the same worldwide in any and all media, whether now known or hereafter devised, in whole or in part, in perpetuity, for any lawful purpose whatsoever without restriction. b. Permission to publish. You also grants us a non-exclusive, irrevocable, worldwide, royalty-free license to reproduce, distribute, and publicly display your Likeness in any and all media, in any locale, in perpetuity, for any purpose whatsoever, without any compensation, save only that we shall not utilize these rights in any way to intentionally and maliciously subject you to ridicule or indignity. You agree that you will not sue or hold us, or anyone who is acting for us with our authority and permission, responsible for any liability resulting from the use of your Likeness. You further agree that we shall be without liability to you for any distortion or illusionary effect resulting from the publication of your Likeness. 2. You will not be paid for granting us any of the above rights. You acknowledge that you will receive no royalties or other payments for our use of your Likeness. The consideration you shall receive in exchange for this Release is the opportunity to have your Likeness publicized, and you agree that this consideration is good and valuable to you and sufficient to support this agreement. 3. You are able to grant this Release. You represent that you own all intellectual property rights that relate to your Likeness. You represent that you are 18 years of age or older and have the right to make this Release. 4. We retain editorial control. This Release does not obligate us to use your Likeness in any manner. We retain the right to edit materials subject to this Release. 5. No injunctive relief. You acknowledge and agree that in no event will you be entitled by reason of our use of your Likeness to seek any equitable remedy, including, without limitation, injunctive relief or any other equitable remedy which would enjoin, restrain or otherwise hinder our use of your Likeness. 6. Governing law. This Release shall be construed and enforced in accordance with the laws of the State of California applicable to agreements of this nature and you hereby consent to the jurisdiction of said State. Sign below to acknowledge and agree.
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Typing your name below will serve as your signature.
Date
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