Please checkmark Yes/No for all questions 1-2. This form also requires your signature on page two.
1. I am willing to have my presentation available on Centre’s website, iTunes University, or any other
on-line video streaming service managed by Centre College.
2. I am willing to have my presentation available on any Centre’s web presence,, only if access is limited
to individuals who work/attend Centre College.
Centre College may audiotape the session in which you appear as a speaker to make it available to those who are unable to attend the
The undersigned does hereby give consent to and authorize Centre College and its licensees to make recordings and transcriptions to use,
It is understood that no substantive editing of the content will be done. Any editing will be of a mechanical nature including but not limited to attaching leaders,
It is hereby acknowledged that any opinions expressed are the sole responsibility of the undersigned and in no matter reflect policies or opinions of the Centre College.
It is understood that in the event that any materials used in this presentation contain the work of other individuals or organizations
Name of Presenter
I decline to be audiotaped because: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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