Consent to and authorize the use and reproduction by The Charles Lea Center, Inc. of any and all photographs and any other audio/visual materials taken of me for promotional material, educational activities, exhibitions, or for any other use for the benefit of the program.
(If you have volunteered at another organization)
(Please provide complete addresses for all references listed)
(Please answer the questions below as completely as possible.)
By submitting this form, you certify that your answers on this application are true and complete to the best of your knowledge. You also grant your permission and consent for us to contact the necessary resources and references to verify your responses on this application.