Publication Permissions Form

I, ___________________________, being known in the Society for Creative

Anachronism, Inc., as _______________________________, do hereby affirm 
that I am the sole/joint author/creator of the work entitled

____________________________________________________ which is a(n) 

article/poem/song/music/drawing/other (specify:________________________).
If I am a joint author/creator of this work, I hereby give the names of 
all others:

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________


I hereby grant to     Guild of Withie and Woolmongers     the right to
distribute my creation to newsletters and researchers in the Society for
Creative Anachronism, Inc., for publication and research.  I realize that
I retain all other rights in the above-mentioned work.

If I am not the sole author/creator of the work I shall assist
the     Guild of Withie and Woolmongers     in obtaining this permission
from all of my co-authors/creators.
The AUTHOR understands that their work (other than ARTWORK or POETRY) may,
for reasons of space availability or editorial concerns, be edited or
abridged by the publishing Chronicler or Editor, unless specifically
requested otherwise.  Furthermore, the AUTHOR understands that such
editing or abridgment will be done with care to maintain the context and
content integrity.  If a submitted work is published in an edited or
abridged form, the Chronicler or Editor will include the text "Edited by
[name] or Abridged from the Original Text by [name].
In addition to this agreement, I request the following: (Please check all that apply.)
___ Please send me a copy of the newsletter or document in which my work
is used.  (Your address will be included on the article only if you
include this item.)  My address is as follows:
__________________________________________________________________________

__________________________________________________________________________

___ Do not edit or abridge my work except to make it Web friendly.

___ I wish my work to be removed from the website after this date.

Signed this _______ day of ____________, being __________ Gregorian.

Sign legal name here _____________________________________________________

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