Skip main navigation

Outdated or Unsupported Browser Detected
DWD's website uses the latest technology. This makes our site faster and easier to use across all devices. Unfortunatley, your browser is out of date and is not supported. An update is not required, but it is strongly recommended to improve your browsing experience. To update Internet Explorer to Microsoft Edge visit their website.

  2. Forms Repository
  3. ADM-19977-E

Permission to Publish/Reproduce Photographs, Written Submissions, and Select Personal Information

Document Number: ADM-19977-E

Description: This form is used to request permission for the right and license to edit, reject for use, or reproduce and/or publish at any time, in print, broadcast, electronic or other media, specific materials and content including photographs, written submissions, and select personal information, including city/county location, program participation, and names.

Comments: Form is protected from modification and enabled for form fill (includes tabbed fields for form completion).

Content Contact: Central Forms Unit

Document Attachment:

ADM-19977-E (English Electronic Version - pdf/670 KB)

Note: If you need this form in an alternate format, please send a message to the Content Contact listed above.

Contact Information

For questions about this form, or if you need this form in an alternate format, please see the Content Contact (listed to the left)

Having trouble finding the correct form? Forms Contacts