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.
Date of Authorization
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature of Author/Rights Holder
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