AUTHORIZATION TO USE
WRITTEN MATERIALS / PHOTOGRAPHS

I, ___________________________________________, hereby authorize the Corporation for National and Community Service (Corporation) and the project sponsor to use, reproduce, and/or publish all written and/or visual materials, including photographs (which are described below) that may pertain to me. I understand that this material may be used in various publications, public affairs releases, recruitment materials, or for other related endeavors. This material may also appear on the Corporation's or project sponsor's Internet Web Page. This authorization is continuous and may only be withdrawn by my specific rescission of this authorization. Consequently, the Corporation or project sponsor may publish materials, use my name, photograph, and/or make reference to me in any manner that the Corporation or project sponsor deems appropriate in order to promote/publicize service opportunities.

Description of Material:

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

__________________________________________
Signature

________________________
Date