Participant Information

(To ensure the accuracy of your response, and to inform you of future events)

Name: ______________________________ Borough/town: ___________________

Phone: (____) _____ -________ Email: ____________________________________

It is OK in the future to contact me for purposes relating to this event. Yes | No

I would be interested in holding up a banner post at the
unveiling ceremony at the New York Public Library on September 1st Yes | No

For good and valuable consideration, I irrevocably grant to the “95 Voices” project and its affiliates the right to publish my photograph and statement in print, video, broadcast, as well as in displays, publicity releases of every nature, Internet and other digital communications media now known or hereafter invented, my name, image, portrait and likeness, whether alone or in conjunction with other photographs, artwork, text or other matter, all without limitation as to duration, frequency or territory.

I acknowledge that my participation as a model and interviewee do not create or vest in me any copyright or other ownership rights in the photographs or other materials resulting from the session(s).

I agree that I shall have no right to inspect any image or control “95 Voices’” exercise of the authorization granted by me hereunder.

Signed: _________________________ Date: __________________________

Digital File Name: _______________ Location: _______________________

While politicians freely voice their opinions and proposals, ordinary Americans rarely reach the broad public with their concerns and ideas for promoting change in the world.
This project is dedicated to bringing the voices of 95 people, chosen at random from all 5 boroughs of New York City, into the public sphere by publishing responses to the following question: “What’s one thing that you’re concerned about in the world today and what, if you had the time and the influence, would you do about it?”

Inspired by the past, this project derives its name from the protest of theologian Martin Luther against the Catholic Church. On October 31, 1517, Luther reportedly nailed his criticisms to the cathedral door in Wittenberg, Germany. His peaceful but forceful statement is today still very much in evidence.

We invite you to answer this question, using the space below or in conversation with one of the 95 Voices volunteers.


A banner displaying the participants and their responses will be made public at 7 pm, Wednesday, September 1st, on the steps of the New York Public Library (42nd Street & 5th Avenue, Manhattan).

For more information, contact us at

95 Voices is independently organized and, though endorsed by citizen action groups, bears no political affiliation to either party.