Dan Moore Designs 2013 Senior Reps

About YOU

with area code

What Social Media websites do you use regularly to connect with friends and family?

If selected as a DMD Senior Rep, I am willing to allow DMD to use the portraits of me for advertising and promotional purposes.


Have you gotten your parents' permission to apply for a spot as a DMD 2013 Senior Rep?

I will ask my parents to send two photographs of me to dan@danmooredesigns.com as soon as I complete this application. I understand that this application IS NOT COMPLETE and WILL NOT BE CONSIDERED until DMD has received my photographs.

By checking the box below, I confirm that I am a high school student that will graduate in 2013. I understand that this program is geared to help promote Dan Moore Designs. If selected as a DMD rep, I agree not to represent any other photographer or studio for the duration of my high school career, and that photographs created by DMD will be used in studio advertising. I also understand that there is no charge for the senior session, and I am under no obligation to purchase additional prints or products. NOTE: Your parents will be required to provide a signature prior to your senior session if you are selected as a rep.