Wufoo
Senior 2012 Model Application
Want to be a member of our exclusive model program at Sam Smead Photocreative?
Sign up now! Space is limited!
Sam Smead Photocreative of Longview is now building it's Class of 2012 Model Team. This group of amazing guys and girls will be the face of Sam Smead Photocreative for the Class of 2012.
Fill out the application, attach an image (one close up and one full length) and we'll contact you with additional information. Those selected will be featured on our displays and advertising for the Class of 2012.
If you would like to learn more about us, go to www.samsmead.com and click the 'seniors' tab. You can view galleries of our work, and get more details about our studio.
2012 Senior Name
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First
Last
Parent / Guardian Name
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First
Last
Please attach a photo of yourself showing your personality
Limit 5mb
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What High School do you go to?
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Address
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Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
United States
United Kingdom
Australia
Canada
France
New Zealand
India
Brazil
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Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Democratic Republic of the Congo
Republic of the Congo
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Email Address
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Parents Email
Home Phone
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Cell Phone
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Birthday
MM
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DD
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YYYY
Tell us about yourself...extra-curricular activites...include any offices held
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Why do you want to be a Sam Smead model?
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Requirements
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I will be willing for Sam Smead Photocreative to use my images in their advertising.
I agree I will not represent any other photographer or photography studio while representing Sam Smead Photocreative
I understand if selected Sam Smead Photocreative will be my senior portait photographer.
I have discussed this application with my parents. They know I am applying to be a part of the Sam Smead Photocreative 2011 Model Team and will help me as needed. I also realize that completing this application does NOT mean I will be chosen
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I Agree
I Disagree
I have a facebook profile and will use it as a way to show off my Sam Smead Photocreative images.
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I Agree
I Disagree
I don't have a Facebook profile
How did you hear about our model program?
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Facebook
Sam Smead Photocreative Website
Friend
Favorites:
Tell us what your favorite things are
Color
Store
Restaurant
music artist/song
things to wear
Do Not Fill This Out