Impact Submission 2024 Logo
  • We want to see your impact!

    Please fill in the details below to submit your impact story. Your insights and experiences are valuable to us, and we look forward to learning about the positive changes your project or event has brought about.
  • Contact Details

  • Organization Details

  • Event/Project Information

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  • Purpose & Details

  • Impact Data

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  • Photography & Video Release Form 

    By providing or submitting any photograph, video, and recording of my voice to Astegos, Inc, I (in my own name or on behalf of any entity or employer named as the provider of the Submission) hereby grant to Astegos, Inc, their representatives (including employees and contracted agents), and their successors an irrevocable and unrestricted right to use, publish, modify, and combine my photograph, video images, and recordings of my voice in promotional materials and publicity efforts. I understand that the photographs, video images and recordings of my voice may be used in publications, print ads, direct-mail pieces, electronic media -- video, cd, dvd, Internet social media platforms -- or other forms of promotion. I hereby release and discharge Astegos, Inc and those acting pursuant to its authority from any and all claims arising out of any use of such photographs, video images and recordings of my voice for the purpose described above.

     

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  • Please review all information and uploads for accuracy and completeness. By submitting this form, you agree to our terms and authorize Astegos Inc. or its assigns to contact you via email, phone, or text message in perpetuity.

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