Undergraduate Release of Information

and Photo Release Form 
 

The Marketing office welcomes the opportunity to send press releases about student accomplishments at Hollins (dean’s list, honor society induction, graduation, etc.) to hometown newspapers. Releases are generated two times a year: in late January for fall term and again in June following commencement. If you wish to have a release sent at any other time of year, please contact us.

Student Full Name 
Hometown 
High School 
Parent or Guardian Name 
Parent or Guardian Address 
How would you like us to refer to your parents in news releases? (i.e., Mr. and Mrs. John Doe of Roanoke, John and Mary Doe of Roanoke, John Doe and Mary Smith of Roanoke, John Doe of Roanoke and the late Mary Doe)
Hollins Class Year 
Major (if declared) 


Hometown Newspaper and Address
(Please list the newspaper, the section or column your paper prints these announcements in, the address and fax number.) 
     
Address:
Fax Number:

Student Photo Release

In signing this release, I give Hollins University the right to use, publish, display, and/or reproduce any video/recorded voice/photographs in which I appear, including the right to edit or use a portion of the video/recorded voice/photographs for promotional publications, videos, alumnae publications, and/or on the Hollins Web site.

I hereby waive any right to inspect or approve the finished photographs, videotape or printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to their use.

I further agree that Hollins University will own the video/recorded voice/photographs and all rights to them, may copyright the video/recorded voice/photographs in its own name, and may grant to others permission to use them.
 

Signature:  

Signature of guardian:               Date:    
[if under 18 years of age]

Marketing Office, 3rd Floor Cocke Building
P.O. Box 9657, Roanoke, VA 24020-1657