ASTA Teacher Awards Media Consent Form

ASTA Teacher Awards Media Consent

Congratulations on your nomination for the ASTA i3 Teacher Awards. To assist us with celebrating these awards and the incredible work being carried out teachers across Australia, we would like to be able to share your stories with the community. We ask that you please provide us with your permission to do so.
I, the undersigned, hereby give permission for the Australian Science Teachers Association and federated state/territory Science Teachers Associations to:
1. publish my name and school name, and details of any prizes in communications and publicity relating to the ASTA Teacher Awards;
2. use the supplied photograph in publications and publicity relating to the ASTA Teacher Awards, including social media posts;
3. use the provided email address for the purpose of invitations to media interviews.
I understand that no obligation or compensation for the use of photographs is implied (i.e. not all Nominees will appear in publicity, and Nominees are not paid for the use of their photos or information).

I agree that the permissions granted by this release form will be considered valid ongoing unless a written variation is received. Please note that once information is shared in the public domain it can be difficult to fully remove if permission is retracted.
Name*

First Name Last Name
School*
Email*
example@example.com
Signature

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This form can be submitted digitally through this platform or printed and filled in manually to be scanned and uploaded with your nomination.
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