Senior First Name

Senior Last Name

Parent First Name

Parent Last Name

Mailing Address

Address Line 1

Address Line 2

City

Country

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State/Province

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Zip Code

Senior Phone

Senior Email

Parent Phone

Parent Email

High School

Select your high school below.

East Rock
Page
Luray
Broadway
Spotswood

What year are your graduating?

Tell us about yourself. Hobbies? Sports? Anything!

Which social media platforms are you on? Fill in all that apply.

Snapchat Username:

Facebook Username:

Instagram Username:

Twitter Username:

I understand I am applying for the senior rep program, I am willing to grand David Foltz Photography permission to use my portrait in advertising.

I agree I will not represent or be photographed by another portrait studio or photography business if I participate in this program.

The Senior Rep Program is designed for rising seniors to promote helpfulness and improve communication within the school through the Shenandoah Valley. You will be a representative of David Foltz Photography.

I am interested in being a representative for David Foltz Photography. If I participate, I will not accept a position from another studio. I understand that David Foltz Photography may use my portraits for, but not limited to; advertising, displays and promotional materials. I understand that there are several obligations such as deadlines that must be met as a representative, and I will perform these duties to the best of my ability.

Any violations of this agreement will result in lost of all credits earned from this program.

I understand and agree to the above policies.

Signature

To accept this contract, type your name below

Finally! Please upload a picture of yourself, selfies or anything!

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