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Collegiate Champions Blog Post Submission Form

Thank you for participating in SOPHE’s Collegiate Champion Program! As a Champion, you are expected to complete several requirements during each academic semester. [SEE THE CHAMPION HANDBOOK FOR MORE] These requirements are meant to help build your program planning and health education communication skills and strengthen your student voice as a SOPHE member! Please fill out the survey below and upload the required documents.
1.Full Name(Required.)
2.School/University (Required.)
3.Name of Event(Required.)
4.Type of Event Hosted(Required.)
5.200-300 Word Blog Post(Required.)
6.Please provide a personal headshot - Picture 1(Required.)
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7.Upload Event Picture 
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8.Upload School Logo(Required.)
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9.PERMISSION: I hereby grant the Society for Public Health Education [SOPHE] and its representatives, successors, and licensee’s permission to use my personal statement, photo, image or likeness in any and all of its publications or any medium, including print and electronic, or other digital media, without payment or other consideration. 

I understand and agree that all materials become the property of the SOPHE. I hereby grant permission to SOPHE to edit, crop, or retouch such materials and waive any right to inspect the final versions or photographs.

I hereby irrevocably authorize the Society for Public Health Education to edit, alter, copy, exhibit, publish, or distribute these statements. photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears.  Additionally, I waive any right to royalties or other compensation arising or related to the use of the statement or photo.
 
I hereby hold harmless, release, and forever discharge the Society for Public Health Education from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

I HAVE READ, UNDERSTAND AND AGREE TO THE STATEMENT AND PHOTO RELEASE TERMS. I ALSO AFFIRM THAT I AM 18 YEARS OF AGE OR OLDER BY SELECTING TO ANSWER "YES."(Required.)
Thank you for your participation in the Society for Public Health Education Collegiate Champion program