SENIOR INFLUENCER APPLICATION | Class of 2025

Name Name First Last
Email Address
Student's Cell Phone Number Student's Cell Phone Number - ### - ### ####
Parent's Name(s)
Parent's Cell Phone Number Parent's Cell Phone Number - ### - ### ####
Parent's Email Address
Full Mailing Address Full Mailing Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
What high school do you attend? You must be a current junior.
Instagram ID, if you have one:
Tell me a little about yourself and why you want to be a senior influencer for Nealy!
Just curious - have you applied to be a senior model for any other photographer?
PORTRAIT AGREEMENT AND POLICIES: By choosing "I agree" you are agreeing to the following terms and conditions.

MODEL RELEASE: I hereby grant Nealy Lanzen the right to use and publish images for purpose of display, editorial work, portfolio, advertising, website, social media, or publication for promotion purposes.

EXCLUSIVITY: Being an influencer for Nealy Lanzen means you commit to work solely with Nealy for your senior photo session.

INJURY: In case of injury before, during, or after the photoshoot, Nealy Lanzen, or the photographer, is not liable in any way.

PARENT/GUARDIAN'S PERMISSION: In order to be a senior influencer, you must have your parents permission.

PORTRAIT AGREEMENT AND POLICIES: By choosing "I agree" you are agreeing to the following terms and conditions.

MODEL RELEASE: I hereby grant Nealy Lanzen the right to use and publish images for purpose of display, editorial work, portfolio, advertising, website, social media, or publication for promotion purposes.

EXCLUSIVITY: Being an influencer for Nealy Lanzen means you commit to work solely with Nealy for your senior photo session.

INJURY: In case of injury before, during, or after the photoshoot, Nealy Lanzen, or the photographer, is not liable in any way.

PARENT/GUARDIAN'S PERMISSION: In order to be a senior influencer, you must have your parents permission. I understand
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Mom or dad, please sign below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.