EPH Image Release and Contact Information

By completing this form and uploading one or more photos, you affirm that you are the photographer of the image(s). You grant Rutgers all rights to use the image(s) in any medium for educational, promotional, advertising, or other purposes that support the mission of the university. You also waive any right to compensation for their use by Rutgers.

Name

Indicate your role in the EPH program (select all that apply):

Current Enrolled EPH StudentEPH AlumniEPH Instructor/Speaker

Year of EPH Graduation

Photo Submission Instructions

Please upload a photo and complete the required fields below. Click the + Upload another photo link if you have more than one photo you would like to submit. There is a limit of four (4) photos per form submission, but you are welcome to submit as many times as you like!

Please note: There is a 35 MB limit on each form submission. If you receive the 413 Request Entity Too Large error message upon submission, it means you have exceeded the file size limit. Try removing one or more photos from your submission, or resizing them.

Submit Your Photos!

Upload Your Photo

Please provide the name of the facility where this photo was taken and the city/state where it is located. (Ex. Rutgers IFNH Building, Cook Campus, New Brunswick, NJ)

Are there any people in this photo other than you whose faces can be identified?

YesNo

Rutgers will need to contact the individual(s) pictured and obtain their permission in order to use this photo. Please provide the name(s) and email address(es) of the individual(s) in the photo. If there is more than one person pictured, please include a brief description of each person (gender, hair color, clothing description, clothing color, etc.) so that we can identify them.