Scholarship Winner Release Form

Scholarship Winner Release Form
I authorize the Coalition in Oregon for Language Teaching (COFLT) to make use of my appearance and personal information on the official COFLT website, for the purpose of publicly recognizing my reception of a COFLT scholarship. I understand that the information I supply will be publicly visible on the official COFLT website and that I may ask to have this information removed at any time.
Full name of student
Full name of parent or guardian (if student is younger than 18)
Date
Clicking the "submit" button indicates that the student and guardian names entered above are the equivalent of a manual signature for the purposes of this release form.
Short biographical sketch with achievements and future plans
Photo of student (optional)
Should be Empty: