Awards Recipient Materials Submission

If you have any questions, contact LCF Awards Coordinator, Emily Austin.

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Preferred Name & Institutional Affiliation (as you wish to have listed in our ceremony program booklet):

First Name

Last Name

Mailing Information:

Address

City

ZIP / Postal Code

State / Province

Country

Email Address

Affiliation

Your current institution(s).

Written Statement (150 words max.)

Photo/Video Release Acknowledgment

Yes

I grant to ACTFL and LCF, its representatives, and employees, the right to use my or my organization’s video/photo, in connection with the ACTFL Awards, including using and publishing it electronically.
I agree that ACTFL and LCF may use my video/photo for any lawful purpose, including but not limited to publicity, illustration, advertising, and Web content, so long as ACTFL and LCF gives me credit as the creator/owner of the video.
If the video/photo I upload depicts any individuals other than myself, it is my responsibility to provide ACTFL and LCF with a signed photo release form for each person shown at the time of submission (releases must include a parent/guardian signature for minors).

Photo

Please upload a high-quality photo in GIF, JPG, or PNG file format only with a 5 MB maximum file size.

Date