Media Release Form
Heritage & Cultural Celebrations
Select which Heritage & Cultural Celebration you are a part of.
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Black History Month
Women's History Month
Asian American Pacific Islander Heritage Month
LGBTQ+ Pride Month
Latinx Heritage Month
Name- as you want it to appear on all materials
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First Name
Last Name
Pronouns
Your Title as you want it to appear on all marketing materials.
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Example: Profitability Expert.
Your Organization as you want it to appear on all marketing materials.
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Example: Studio 5 Learning and Development.
Your email where attendees would contact you
example@example.com
Phone Number
Format: (000) 000-0000.
Please upload a short bio (150 words or less) .
Browse Files
Drag and drop files here
Choose a file
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Please upload a headshot.
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Browse Files
Drag and drop files here
Choose a file
We strongly recommend a high-resolution headshot on a neutral background, preferably 1000x1000 pixels, mid-torso up. When choosing your photo, please keep in mind it will be used in videos, social media, and advertisements to promote HCC.
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What are your social media handles (if you would like us to tag you in our social media posts)
What does your participation in this Heritage & Cultural Celebration mean to you personally?
A podcast, book, film or documentary, or interactive learning that you recommend that will continue the learning of our audience
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0/50
An interesting fact about yourself
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0/245
Who or what inspires you?
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0/245
Anything else we should know?
Media Release Form
Signature
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