Social Media Consent Form Question Title * 1. Name Question Title * 2. Organization: Question Title * 3. Acknowledgements: I grant permission for the organization named above to use photographs or videos of me and information related to my experiences with the organization on Facebook, Instagram, X, Tik Tok, or any other social media platform. I grant permission to the organization named above to edit and alter photographs or videos of me for social media. I grant permission for the organization above to use photographs or videos of me on social media for the purpose of marketing and advertising. I agree that I will not receive any monetary compensation. I confirm that I am of legal age to give my consent. Question Title * 4. I prefer that: My full name be used My first name only be used I remain anonymous A nickname be used: (please specify) Question Title * 5. I consent to the use of social media given the acknowledgements above: I consent I do not consent Question Title * 6. Signature: Question Title * 7. I acknowledge that by entering my name above I am providing a digital signature. Agree Question Title * 8. Date Date Date Done