Walsh
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First Name
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Last Name
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Email
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Telephone
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What is your affiliation with Walsh College?
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Photo authorization:  *I hereby authorize Walsh to use biographical information I provide, and any and all reproductions of my likeness, made on this release form for publicity, commercial, promotional or other purposes, with no compensation to me. I also consent to the recording of statements, photographs, and/or audio or video recordings and the unlimited use of the same by Walsh for publicity, commercial, promotional or other purposes. All rights, title and interest in any statements, photographs, and/or audio or video recordings shall be the sole property of Walsh, and I hereby waive any claims relating to use of the same by Walsh. 
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Contact Name:  Diane Fisher, Administrative Assistant, Walsh College
Contact Phone:  248-823-1262
Contact Email:  dfishe4@walshcollege.edu