SENIOR INFLUENCER APPLICATION | Class of 2023

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:
Tell me a little about yourself! How would you describe your style? What activities are you involved in? What's important to you? I would love to get to know you a little!
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, Facebook, Instagram, or publication for promotion purposes.

EXCLUSIVITY: Being a model for Nealy Lanzen means you commit to work solely with Nealy for your senior pictures. This experience is totally free, the only cost is for your professional makeup on the day of the shoots. You also agree to work with Nealy for your full senior session, and agree not to be a senior model for any other photographers.

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 model, you must have your parents permission. An informational meeting (or Zoom meeting) will be scheduled for late winter 2021!

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, Facebook, Instagram, or publication for promotion purposes.

EXCLUSIVITY: Being a model for Nealy Lanzen means you commit to work solely with Nealy for your senior pictures. This experience is totally free, the only cost is for your professional makeup on the day of the shoots. You also agree to work with Nealy for your full senior session, and agree not to be a senior model for any other photographers.

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 model, you must have your parents permission. An informational meeting (or Zoom meeting) will be scheduled for late winter 2021! I understand
Draw your signature into the box below.

Draw or Type

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Full Name

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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.
Thank you for taking the time to fill out this form! If there is anything else you would like Nealy to know, please leave a comment here!