The Pharmacy Guild of Australia may use this Information and Representations of me (eg photographs and other images) to be stored, retrieved, reproduced, published, distributed and transmitted in any form or by any means whether electronic, mechanical, or otherwise (including photocopy, recording, printing, photographic, internet) by The Pharmacy Guild of Australia for the purposes of clinical and public education, product training, marketing and promotion programs.

The Pharmacy Guild of Australia may make reference to my full name in marketing publications and promotional programs

I am not entitled to any royalties, fees, or other compensation in return for any of these materials being used that form part of this deed.

This consent shall survive the termination of any relationship I have with The Pharmacy Guild of Australia and shall continue to bind me and my estate.

I have been informed and understand that materials obtained may be used and distributed for the purpose of the below.

Consent is given for a period of 24 months from the date of signing this document. If consent needs to be withdrawn, then you should contact the Victorian Branch on 03 9810 9999