I authorize the Service Employees International Union (SEIU), and its locals and affiliates, to publish the information I have provided, including my name, photograph, statement, video and any other information, in any forum including the internet and email. I confirm that the information provided does not contain any confidential or protected financial information or any other information the disclosure of which would violate federal, state, or local laws, and that the information I am submitting is truthful to the best of my knowledge. I understand that SEIU may edit the information I have provided if it deems it appropriate. I hereby release SEIU from any liability and claims that I may have arising out of the use and publication of this material. I confirm that I am at least 18 years of age and that all information in the material I have provided to SEIU is true and accurate to the best of my knowledge.