Media Consent Form | Methods For Change

Testimonial Participation Agreement

The following statements are meant to ensure you have adequate information about how your testimonial will be used and what will happen to the data you provide.

The Institute for Methods Innovation (IMI) will be responsible for storing and processing the data that you submit.

Communication consent: IMI and Methods for Change (MFC) may use my information to communicate with me about events, courses, workshops, associated evaluations, and future opportunities on related topics.
Media consent: I understand and consent to IMI and MFC using (now and in the future) my written testimonial, images, audio and videos (i.e., ‘media’). These media may be featured on websites, social media, videos, brochures, newsletters, and other publications or platforms. My consent is permanent and irrevocable. I may not claim future payment for the use of these media.
Publicity consent: I consent to the public identification of my name (or other professional identifier) as a testimonial provider.

Please indicate whether you understand and agree with the statements above, and consent to participate as follows:

I consent to provide a testimonial and for my responses to be used (as indicated above) for related purposes.

First name

Last name

Affiliation (if any)

We thank you kindly for your time spent filling out this consent form. We look forward to your feedback and if you opted for an online interview, one of our team members will contact you shortly.

Please click Submit to send your responses.