I hereby consent to the participation in interviews, the use of quotes, and the taking of photographs, movies or video tapes of the student named above by Robert Russa Moton National Alumni Association.
I also grant to Robert Russa Moton National Alumni Association the right to edit, use, and
reuse said products for non-profit purposes including use in print, on the internet, and all other forms of media. I also hereby release Robert Russa Moton National Alumni Association and its members from all claims, demands, and liabilities whatsoever in connection with the above. NOTICE OF NONDISCRIMINATORY POLICY: The Scholarship Committee of the Robert Russa Moton National
Alumni Association encourages individuals of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to individuals applying for scholarships. We do not discriminate on the basis of race, color, national and ethnic origin in the disburs.ement of any scholarship award.