Model Photo Release Form

Introductory Statement:
The ACS would like your permission to include your photograph in which you appear. To indicate your permission, please input your name, email address and today's date and check the box acknowledging your agreement with the statement below.

Photo Upload

The American Chemical Society (ACS) requires copyright assignment for content it publishes. This applies to all departments and divisions within ACS. However, in rare cases, where it is impossible or impractical for the ACS to own/obtain copyright in and to Content (including text, figures, tables, and non-text material). Thus, the photographer needs to sign a Non-Exclusive License Agreement. Please provide the name and email address of the photographer of your photo.

Social Media

The ACS is hosting a social media campaign to raise awareness of its Outreach Volunteers of the Year program. The ACS will feature all awardees via weekly profiles on the main ACS social media accounts. To participate on social media, please enter your handles in the fields below.

Release Agreement

I hereby grant to the American Chemical Society royalty-free permission, including nonexclusive world rights in all languages, to reproduce in all formats including but not limited to print, microform, electronic, and/or CD-ROM, and include my likeness as shown on for the Outreach Volunteer of the Year recognition program.
Statement: *
Agreed to and accepted by:
Questions about this program? Email
American Chemical Society