Welcome to the incoming Georgetown MS-ESM Class! 

If you have any questions regarding this form, please contact the MS-ESM Program at msesmadmissions@georgetown.edu.

Please enter your name exactly as you would like it to appear in program records. If there is a name you would prefer to use instead of your legal first name (for example "Jim" instead of "James"), please complete the "Preferred First Name" field.

The MS-ESM Program welcomes your partners and families into the ESM community. If you would like others to be included in relevant events and opportunities, please complete the questions below:

Authorization and Disclosure- TO BE READ IN ITS ENTIRETY

The information provided in this form and your MS-ESM application materials may be shared by the MS-ESM Program for the use of students, faculty, administration, and staff of the MS-ESM Program, the Graduate School of Arts and Sciences, and the McDonough School of Business of Georgetown University. Information to be shared may include:

• Student's photograph
• Hometown (city, state, country)
• All previous post-secondary educational institutions attended, including major and degree from such institutions.
• Previous work experience, including company name, industry, and function.

Class Recordings

By attending classes, you consent to the making and use of classroom recordings that may include your images or voices in accordance with the McDonough Classroom Recording Policy. These recordings will not be made available to the public. Contact the MS-ESM Program at msesmadmissions@georgetown.edu if you have concerns regarding appearing in a class recording, so you can discuss appropriate accommodations. Instructors are permitted, but not required, to record their classes. If approved, recordings may be made of every class session or for certain sessions only. Contact the Program Office if you would like full details of the recording policy prior to arrival.

Photography Release

I hereby authorize Georgetown University to publish photographs taken of me, my name, graduation year, degree program, and likeness, or persons under my legal guardianship, for use in Georgetown University marketing and advertisements (both paid and unpaid), including, but not limited to: print, web, digital, out-of-home, and social media, as well as by any outside third party interests. In consideration for my voluntary participation in marketing products produced by Georgetown University, or any outside third party interests, I agree that I will receive no financial compensation. Furthermore, I agree that participation in any marketing or advertising products produced by Georgetown University, or any outside third party interests, confers no ownership or special rights whatsoever. I release Georgetown University, its employees, and any outside third party interests from any claims of liability by me in connection with my participation in the production of these photographs. If you have any questions about the usage of your photographs, or if you do not authorize this release, please email the MS-ESM Program at msesmadmissions@georgetown.edu.

Consent to Recording and Releasese

For good and valuable consideration, the receipt and sufficiency of which I acknowledge, I hereby irrevocably grant to Georgetown University and persons authorized by it all right and permission to make or cause to be made photographic, audio, visual, and audiovisual recordings of me during recording sessions conducted by the University at PHYSICAL LOCATION or Online during the ONLINE / IN-PERSON PROGRAM, and to use such recordings, and to permit third parties to use such recordings, including my name, image, voice, and likeness, in all forms of media now known or hereafter devised, throughout the world and in perpetuity, for any and all commercial and noncommercial purposes. I agree that the recordings may be used and reused, in whole or in part, and alone or in conjunction with other photographic, audio, or audiovisual works. 

Without limiting the generality of the foregoing, I understand and acknowledge that the recordings may be used for the following purposes and in the following manner, among others:

• conference presentations
• educational presentations or courses
• informational presentations
• news and media releases
• promotional purposes
• internet, television, radio, and other media channels

I acknowledge and agree that the recordings, together with any copies or works derivative thereof, are and shall remain the sole and exclusive property of Georgetown University, and that the University is not obligated to exercise any of the rights granted in this Agreement. This release shall be binding upon me and my heirs, legal representatives, and assigns. This is the entire agreement between me and the University concerning the subject-matter hereof, and it supersedes all prior oral and written understandings, communications, and agreements. I hereby release and discharge Georgetown University and its successors and assigns from any and all claims, demands, and causes of action of any nature whatever arising, directly or indirectly, out of or in connection with this Agreement, including without limitation any alleging intellectual property infringement, defamation, or violation of rights of privacy or publicity or moral rights.