Forms

If you are interested in working with me as a model, please fill out and submit the Model’s Questionnaire below.  Please be aware that the “submit form” button does not work properly for everyone. To help solve this problem, after you submit the form, send a separate email to me at scottmatthews1957@yahoo.com and tell me you sent the form.  If I don’t receive it, you can highlight the form, copy it, and paste it in the body of an email, then send it to me that way. Of course, you can always send the form as an email in the first place.  Sorry for the trouble.  I look forward to the possibility of working with you! Thanks!

Model Questionnaire

Please fill out as many blanks as you can as they will help us assign you to projects for which you are best suited.  Deliberately deceptive answers can seriously jeopardize your future in the modeling industry. 

Name:

Address:

City:State:Zip Code:

Stage Name:

Home Phoneemail address:

Cell Phonealt email add:

Website:

Driver’s License:Y N       Passport:Y N

Race: Date Of Birth:Age:

Sex:M F Hair Color:Eye Color:Height:ft in

Weight: lbs.  Shoe Size: Hat Size: Pants:

Males – Chest: inches. Waist: inches. Arms: inches. Shirt:

Females – Bust: inches. Waist: inches. Hips: inches. Blouse:

Skirt/Dress: Swimsuit:

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Please list types and locations of the following.

Scars or Deformities:

Birthmarks:

Tattoos:

Piercings:

Modeling/Dancing/Acting Experience:

Work Experience:

Educational Experience:

Talents:

Sports:

Allergies:

Phobias/Fears:

Special Interests:

Can you swim?: Y N

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Which of the following types of posing are you willing to do?  Pay is commensurate with the different types of modeling.

Fully Clothed:Y N  Lingerie:Y N   Swimsuit:Y N   Draped:Y N   Underwear:Y N

Implied Nude: Y N    Partially Nude:Y N     Artistic Nude:Y N

What types of travel are you willing to do?

Local:Y N       Daytrip:Y N        Weekend Trip:Y N        Longer:Y N 

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I certify that the above answers are true to the best of my ability.

Signature:____________________________________________________________________

Date:________________________________________________________________________

Click here to submit >>>>> <<<<< Click here to submit

 

You will be asked to sign the following model release before we work together.  Please familiarize yourself with it.

Model Release
 

In consideration of my engagement as a model, upon the terms herewith stated, I hereby give to Bootheel Photo/Scott Matthews, his heirs, legal representatives and assigns, those for whom Bootheel Photo/Scott Matthews is acting, and those acting with his authority and permission:

a) the unrestricted right and permission to copyright and use, re-use, publish, and republish photographic portraits or pictures of me or in which I may be included intact or in part, composite or distorted in character or form, without restriction as to changes or transformations in conjunction with my own or a fictitious name, or reproduction hereof in color or otherwise, made through any and all media now or hereafter known for illustration, art, promotion, advertising, trade, or any other purpose whatsoever.

b) I also permit the use of any printed material in connection therewith.

c) I hereby relinquish any right that I may have to examine or approve the completed product or products or the advertising copy or printed matter that may be used in conjunction therewith or the use to which it may be applied.

d) I hereby release, discharge and agree to save harmless Bootheel Photo/Scott Matthews, his heirs, legal representatives or assigns, and all persons functioning under his permission or authority, or those for whom he is functioning, from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form whether intentional or otherwise, that may occur or be produced in the taking of said picture or in any subsequent processing thereof, as well as any publication thereof, including without limitation any claims for libel or invasion of privacy.

e) I hereby affirm that I am over the age of majority and have the right to contract in my own name. I have read the above authorization, release and agreement, prior to its execution; I fully understand the contents thereof. This agreement shall be binding upon me and my heirs, legal representatives and assigns.

Dated: _____________________________________

Signed:_____________________________________

Full name:____________________________________

Address:____________________________________

City:_______________________________________

State/Zip:____________________________________

Phone:______________________________________

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