Media Content Declaration Form
Submit and declare details about your media content. Please provide accurate information for each section below.
Content Title
*
Type of Media Content
*
Please Select
Image
Video
Audio
Document
Other
Creator/Submitter Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Date of Creation or Submission
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Brief Description of Content
*
Upload Media File
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Intended Use or Distribution
*
Please Select
Internal Use
Public Release
Commercial Use
Educational Use
Other
Ownership Status
*
I am the sole owner
Shared ownership
Third-party content (with permission)
Additional Notes (optional)
Submit Declaration
Should be Empty: