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  Hearts & Minds - Information for ChangeSM

  Seniors for ChangeSM
 Consent Form

You, too, can help inspire a better world

Dear Potential Participant:

Hearts & Minds welcomes your possible participation in the Seniors for ChangeSM program. Seniors create thought-provoking, inspiring posters, essays, poetry and other works of art. They also write letters to their elected representatives. All of this may then be seen locally and internationally through our website and other media. This program is in New York City and eventually will expand all over the world.

We plan to film and/or photograph the participants and their work to raise awareness of poverty, the environment or other important issues in NYC and around the world, and also to support and promote Hearts & Minds' public service.

Hearts & Minds Network, Inc. is an all-volunteer, nonprofit 501(c)(3) tax exempt organization that uses mass communication to promote self-help, volunteering and community service. Our work empowers people all over the world to work on poverty, the environment, human rights, democracy, addictions and other important issues.

Founded in 1996, we are uniquely dedicated to using mass communications to inspire, motivate, inform and empower as many people as possible - in New York City, nationwide and beyond.

Our website - - provides resources, links and practical advice that enable millions of people worldwide to help themselves and others in need. We bring together young volunteers and experienced professionals to help solve persistent social problems.

Our Global Survival Campaign - - directly addresses terrorism, poverty and environmental issues that threaten people everywhere.

We appreciate your interest in helping us help others.

Please carefully review the permission form below. If you have any questions, feel free to ask. If agreeable, please fill out and sign. Thanks.


William Blackman

Please go to Consent Form for Participants

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This web page and entire website Copyright: 1997 - 2015 by Hearts and Minds Network, Inc. Photo 2007 by Bill Blackman - online October 30, 2007, latest changes December 14, 2007

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