Emerson Channel Event Filming

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Name (First, Last):
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Emerson ID Number:
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Emerson Email Address:
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Organization Name:
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Department Name (if applicable):

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Organization Email:
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Organization Phone Number:
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Describe your Event:
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Event Location:
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Event Date(s):
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Estimated Number of Attendees:
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Will there be Non-Emerson Students in Attendance?
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Any additional comments, questions, or concerns?

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I agree to let Emerson Channel use or post any footage filmed at their discretion.
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