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My Reason Badge

My Reason Badge Order Form

1. Are you employed with Marathon / Directly supervised or with a Contractor
My Reason Badge Sample
My Reason Badge Sample
2. Contact Information
No more than 45 charters including spaces. All custom commitments will be reviewed.
If you prefer not to input a custom commitment and use a a commitment from a list, skip and leave blank by clicking "next"
4.

If you prefer not to input a custom commitment please select one from the list below.

Please upload a photo of your reason for working safely. You may pick anything you wish, but please remember that all submissions will be reviewed.
5. Photo File Upload
Browse to your photo then remember to click upload.  The upload process may take some time. *This question is required.
Photo Release

If I picked that I am willing to share either my photo and/or story. I hereby give Marathon Petroleum Company LP and its Affiliates (Marathon Petroleum), and anyone acting with its permission and authority, the absolute, royalty-free right and permission to copyright and use, reuse, publish and republish in print, electronic or video format the photographs and images I upload to www.mpcsurveys.com, including all photographs containing my likeness or image, without restriction as to changes or alterations, or reproduction.    I further release all claims against Marathon Petroleum with respect to copyright ownership or publication, including any claim for compensation related to the use of the photographs or images I upload. I hereby waive any right that I have to inspect or approve the finished product or products.    I warrant that I am of full age and have every right to contract in my own name in the above regard, or that, where accepting the terms and conditions on behalf of a named minor, I am the parent or legal guardian of the minor contained in the photographs or images, having full legal authority to provide the consent and release contemplated hereby on such minor’s behalf; I further warrant that I have the right to upload the photographs or images uploaded and do hereby give my consent pursuant to the above terms and conditions.    By clicking “Submit,” I acknowledge that I have read and agree to the terms and conditions listed above.
6. Are you willing to share your photo and commitment for potential use in future Detroit Refinery communications? *This question is required.
Thank you for your submission.


If you have questions or concerns about what was submitted or when you will get the card contact:
Frank Ebbert at 3135517948 or via email at frankebbert@marathonpetroleum.com