PERMISSION TO PUBLISH FORM

 

 

I hereby give permission to _______________________ and to the Director of the

                                               (instructor's name)

 

First-Year English Program at Marquette University to use my written text,

 

 

___________________________________________________________________,

                                               (title)

 

for in-class educational purposes at Marquette University. I understand this use may

 

 

entail publishing the essay in print or electronic form solely for the purposes of

 

 

instruction at Marquette University. I further acknowledge that I will receive no

 

 

remuneration for granting this permission.

 

                • I will submit my written text (check one):

 

                      _____ electronically (send to krista.ratcliffe@marquette.edu)

 

                      _____ hard copy (give to instructor)

 

                • I wish my name (check one):

 

                        _____ to be removed from the written text

 

                        _____ to remain on the written text

 

Signed,                                                                         Date _____________________

 

_____________________

(student signature)

 

 

Print Name:

 

_____________________