Example of a form that a student signs to give the publisher permission to put his/her work online. It should be filled in using pen, not pencil.

Permission to Publish Student Work Online

I give Christina Jones permission to publish:

______ my writing
______ my photograph
______ my artwork

on an Arizona Western College web page on the Internet.
 
Name: ____________________________

Signature: _________________________

E-Mail or address: __________________
_________________________________

Date: ____________________________