Release to Reproduce Images

RELEASE TO REPRODUCE IMAGES

I hereby authorize North Carolina Literary Review (NCLR), published by East Carolina University and the North Carolina Literary and Historical Association, hereafter referred to as the “Journal,” to publish photographs, drawings, illustrations, or any other art, hereafter referring to as the “Image(s),” that I have voluntarily provided, described as follows:

[INSERT DESCRIPTION OF IMAGE(S) TO BE PUBLISHED]

The Work described should be credited as follows:

[INSERT CREDIT STATEMENT FOR IMAGE(S)--I.E., PHOTOGRAPH BY AND/OR COURTESY OF]

The Image(s) will be used to accompany the article [INSERT TITLE] by [INSERT AUTHOR NAME] in the [INSERT YEAR] issue of the Journal, which may be printed, published online, or both.

I hereby grant NCLR worldwide rights for all editions (including electronic/digital formats), use in promotional materials (such as the NCLR website), in subsidiary licenses (such as translations or book clubs), and versions made by nonprofit organizations for blind or physically handicapped persons.

I attest that I have full authorization to consent to publication of the Image(s). Further, I hereby release and hold harmless the Journal from any reasonable expectation of privacy or confidentiality associated with the above-specified Image(s).

I further acknowledge that signing this agreement constitutes a waiver for royalty fees. Neither I nor any other party who may share ownership of the previously described Image(s) (whether in the past or future) will receive financial compensation at any time for the publication of the Image(s) in NCLR.

Sign the following release and mail to: NCLR, attn.: Margaret Bauer, Editor; ECU Mailstop 555 English, Greenville, NC 27858-4353 PERMISSION GRANTED BY:

[PRINT NAME OF AUTHORIZED PERSON]

Artist(s) Contact Information Address 1 Address 2 City, State, Zip Phone Number Fax: optional Email Address

DATE ______Authorized Signature

The signature above indicates that the signer assumes all responsibility for questions of copyright and privacy pertaining to the use of the Image(s).