MINISTRY OF MUNICIPAL AFFAIRS
PUBLICATION CONSENT FORM
CAREER PATHS FOR SKILLED IMMIGRANTS PROGRAM
The personal information collected from your Interview is collected under the Career Paths for Skilled Immigrants
Program (the “Program”), and is subject to the provisions of the British Columbia Freedom of Information and
Protection of Privacy Act. As set out below, your personal information, including the fact that you have participated in
the Program, may be used to publicize and promote the Program, such as inclusion in a Program “success story”.
For more information regarding the collection, use or disclosure of your personal information, please contact:
settlement@gov.bc.ca
For good and valuable consideration (the receipt and sufficiency of which is acknowledged),
I hereby give my consent to ____________________________ [legal name of
contractor/photographer], under contract with the Province of British Columbia, as
represented by the Minister of Municipal Affairs (“Province”), to interview, record,
photograph or film me as part of a Success Story Project for the Career Paths for Skilled
Immigrants Program (“Recordings”).
I hereby grant to the Province, its employees, representatives, licensees and assigns, the
right to use, reproduce, modify, publish or distribute my Success story, voice, image or
likeness in the Recordings for any lawful educational, advertising, promotional, commercial
and informational purposes worldwide, and hereby release and discharge any right, title or
interest that I may have in the Recordings or in any remuneration therefrom.
SANDEEP NAMMI
____________________________________
(Print name)
I understand that the Province reserves the right to edit the content of success stories, testimonials and/or
other materials containing my personal information for clarity and brevity purposes.
Client Signature
Date (YYYY/MM/DD)
2021/09/29
INFORMATION BELOW THIS LINE NOT FOR PUBLICATION
Client
Name
P.R. #
Phone
Contractor Representative
Name
Last Updated: May 2021
Signature
Phone