Article Release Form

Article Release Form
Grant permission for publication or use of your article by completing this form.
Author's Full Name*
First NameLast Name
Author's Email Address*
example@example.com
Author's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Author's Mailing Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Article Title*
Type of Article*
Brief Summary of Article Content*
Intended Publication or Use (Where or how will the article be published or used?)*
Are there any restrictions or special instructions regarding the use of your article?
I certify that I am the original author or have the legal rights to authorize the publication/use of this article.*
Yes, I certify and authorize the release of this article for publication/use as described above.No, I do not authorize.
Date of Authorization*
MonthDayYear
Date
Signature of Author/Rights Holder*
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