Sample Permissions Form

PERMISSION FORM

I, __________________________________________, agree to allow

_____________________________________ to photograph me (and/or my property) and

to use any photograph in a class project for ______(course name)___________________.

I understand that the instructor, ____________________ and other students in the class may see the photograph(s).

Check any that apply:

______ I request that my name not be used in any written form.

______ I request that any photo used be anonymous (e.g., face hidden).

____________________________________

(Photographic subject)

____________________________________

(Student photographer)