SAMPLE  RELEASE  FORM 

  • To

    The Managing Editor,

    DJ Books Publications

     

    Dear Sir,

     

    Ref:

    Author(s) name(s):

    ..........................................................................................................................................................................

    Title:

    ..........................................................................................................................................................................

     

    I/we grant the permission requested on the terms stated in this letter.

     

     

    The undersigned hereby represents that they have the right to grant the permission requested above, and that the mate- rial does not infringe upon the copyright or other rights of third parties. The undersigned is the owner/author of such materials.

     

    [If material was created by a minor, use the following wording in place of the paragraph above: “I hereby grant permis- sion to reproduce and publish the materials of my child/children (list names here) in educational publications and any promotional materials published or copyrighted by DJ BOOKS PUBLICATIONS, its successors and assigns. I understand that the material may be published in any form or format that the publisher may desire.”]

     

     

    CREDIT LINE TO BE USED:

     

      

    Signature:....................................................................................

    Date:..........................................................................................

     

    (Corresponding author Name):

    ...........................................................................................................................................................................

    Address:..............................................................................................................................................................

    Email:...................................................................................................................................................................

    Moblile:................................................................................................................................................................)