MODEL INFORMATION FORM

Name

First Name

Last Name

Phone *

(###)

###

####

Gender *

Female

Male

Are you over the age of 18+? *

Yes

No

Are you able/willing to pose nude? *

Yes

No

Implied only

Nudity on Location *

If yes to Nudity, are you comfortable with being nude in an outdoor location? (With all precautions to your safety and location in mind.)

Yes

Maybe, if it is a secluded place

No

BODY PAINT *

Please check all that you are comfortable and your body will NOT react to*. *If unsure of an allergic reaction, please do NOT check it, we can always discuss certain ones later if needed.

Acrylic Paint

Natural Clay

Baby Powder

Baby Oil (or other body oil for shine)

Coconut Oil

NONE OF THE ABOVE

Describe your Personality *

I will use this information to cast as some of my projects require moods, emotions and styles that are best suited to the personality. We all can act but how I aim to get greater depth in my projects is to create the most authentic form of the theme as possible. Please choose all that apply to you.

Introverted

Extroverted

Open to experiences

Pay Attention to Details

Free and Go With the Flow

Goal Directed

Organized

Emotional

Logical

Excited and Playful

Relaxed and Calm

By checking the box below, I understand that the images produced may be used for publication, marketing materials (for Sam Kaczur), fine art prints and/or products for sale. And by clicking the box below I have agreed that the COMPENSATION that I have selected above is fair and what I would like to recieve in return for my modelling expertise.

Yes, I agree.

Unfortunately, I cannot guarantee that we will work together as I may not have availability or able to use your look at this time. I will reply to your submission for more details if needed and to let you know if your look will work within my ideas. If you would love to work with me (on a specific idea, or wish to have images sooner) I am available to hire to create images that you can use for your portfolio and social media. *

Yes, I understand.