AFSCME DC47 Member Spotlight

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* 1. Enter the Union member's information:

Full Name

Local

Email Address

Phone Number

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* 2. What is the Union member's position/title?

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* 3. How many years has the Union member been a Union employee?

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* 4. Please enter positive remarks about what the Union has done for the Union member.

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* 5. The fun part! Please enter a fun/interesting fact about the Union member.

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* 6. I hereby grant the AFSCME District Council 47 permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.

I understand and agree that all photos will become the property of AFSCME District Council 47 and will not be returned.

I hereby irrevocably authorize AFSCME District Council 47 to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo.

I hereby hold harmless, release, and forever discharge AFSCME District Council 47 from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

I HAVE READ AND UNDERSTAND THE ABOVE PHIOTO RELEASE. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENTS/GUARDIANS AS EVIDENCED BY THEIR SIGNATURES BELOW.

I agree to the permission terms listed.

I do not agree to the permission terms listed.

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* 7. Please upload your picture here by clicking CHOOSE FILE, or send to: smora@dc47.org

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.