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Permission Form

Your signature is required giving SABES permission to

  1. •  Publish your writing in the 2009 edition of “Do the Write Thing”
  2. •  Publish your name on the SABES web-site (www.centralsabes.org).

Your writing may also be used for future 'Do the Write Thing' publicity purposes.

Please :

  1. •  print
  2. •  sign
  3. •  mail this form to:

Joanne Harrington
SABES, Box 4
670 West Boylston Street
Worcester , MA 01606

1) Permission to publish writing in the 2009 edition of “Do the Write Thing”
Check only ONE
___
Yes, I give permission to publish my writing in the book
___
No, I do NOT give my permission to publish my writing in the book

2) Permission to publish name online

Check only ONE
___
Yes, I want my name to appear online
___
No, I do NOT want my name to appear online
Title of Writing
 _________________________________________
Student’s Name (print)
_________________________________________
Program Name (print)
_________________________________________

Signed: ________________________________
Date: _____ / _____ / ________