*Please upload your high resolution headshot in color using only JPG or PNG file types. The file size should be at least 1MB. Do not include photos with borders. For good and valuable consideration, I give the National Committee for Quality Assurance and its successors & assigns, employees, agents and directors (collectively, “NCQA”), a perpetual, irrevocable, royalty-free license to exercise all copyright and all other legal rights, including but not limited to any publicity or privacy rights I may have, to my image and likeness submitted to NCQA by me (collectively, the “Materials”) and I relinquish any rights, title and interest I may have in connection to the Materials. I also give NCQA the right to use my name and any biographical data I give in connection with the Materials. I agree that I won’t sue NCQA for its use of the Materials and related name and biographical data. I am 18 years of age or older and I have read and understand this release. This release is to be governed by the laws of the District of Columbia and I consent to the exclusive jurisdiction and venue in the state and federal courts sitting in District of Columbia.