To give Rational Island Publishers permission to publish your writing or artwork (including photographs), please print the form below, mark the appropriate place in the second paragraph, complete and sign the form, and mail it to:
Rational Island Publishers
719 2nd Avenue North
Seattle, Washington 98109
USA
I hereby give Rational Island Publishers permission to print the attached article/artwork in Present Time and/or one of its other journals (any of which may be eventually posted on the web), and to list me as the author/artist. I understand that my writing may be edited/my artwork may be touched up or cropped.
I also do ____ do not ____ give Rational Island Publishers ongoing consent to publish my writing or artwork in any RC publication, at any time in the future. This would include any parts of my letters to Tim Jackins or other RC leaders (unless I specifically indicate in the letter that I don't want it published), my postings to RC e-mail discussion lists, and any submissions to Present Time or other RC newsletters or journals.
Signed:
| _______________________ | _______________________________ | _____________ |
| First Name | Last name | Today's date |
| ____________________________________________________________________ | ||
| Address | ||
| ____________________________________________________________________ | ||
| The Re-evaluation Counseling Communities 719 Second Avenue North Seattle, Washington 98109 USA |
Email: Home Page: Voice: Fax: |
ircc@rc.org http://www.rc.org/ +1-206-284-0311 +1-206-284-8429 |