THE UNIVERSITY OF TEXAS AT AUSTIN
305 E. 23rd Street, CLA 3.306 A3100. Austin, Texas 78712-1098
(512) 471-5116. FAX (512) 471-5049. www.utexas.edulcola/depts/geography/
CONSENT AND WAIVER
To Student, Faculty, and Staff:
I hereby grant full permission to the Department of Geography and the Environment/Urban Studies at
The University of Texas at Austin to prepare, use, reproduce, publish, distribute, and exhibit my picture
and research interest in connection with the production of the department website located at
http://www.utexas.edu/cola/depts/geography
for informational or any other professional purpose deemed necessary in the interest of the mission of
the Department of Geography and the Environment at The University of Texas at Austin.
I understand that by granting my permission, this information will be published so long as I am currently
enrolled or employed as a member or graduate student in the Department of Geography and the
Environment. If at any time during or after my enrollment, I no longer wish to have my photo or
research interests published on the Department of Geography and the Environment web site, I may
contact the department web administrator to have this information removed.
I hereby waive all rights of privacy or compensation, which I may have in connection with the use of my
name and/or picture in connection with said web site and any use to which the same or any material
therein may be put, applied or adapted by the Department of Geography and the Environment at The
University of Texas at Austin.
NAME:
__________________________
SIGNATURE:
__________________________
DATE:
__________________________