Film Archival Inclusion Consent Form
Please provide your information and consent for inclusion in the film archive.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Project or Film Title
*
Your Role or Relationship to the Project (e.g., Participant, Interviewee, Contributor)
*
Please Select
Participant
Interviewee
Contributor
Crew Member
Other
Signature (Please sign below to confirm your consent)
*
Date
*
-
Month
-
Day
Year
Date
Additional Comments (optional)
Submit Consent
Submit Consent
Should be Empty: