This form grants Ecology permission to use images and other materials.
In submitting this form, you agree to the following:
I authorize the Washington State Department of Ecology to use my quote(s), photo(s), audio, and/or video, identified below, for educational or promotional purposes in any media, including Ecology websites.
I understand that my name may be used on these materials unless I request otherwise.
To request this form in an alternate format, contact Ecology's ADA Coordinator by email at email@example.com, or call 360-407-6831.
People with impaired hearing may call Washington Relay Service at 711. People with speech disability may call TTY at 1-800-833-6384.