Release of Student Work for Publication

Course Number and Title __________________________________

Semester + Year __________________________________

I hereby give my permission for my instructor, _________________________________ , to use and reproduce my work in this course (written class work; tests and examination responses; electronically produced materials such as e-mail messages, Website files, transcripts from electronic dialogue groups, original graphics submitted as part of the course assignments) for research and publication purposes.

This permission is granted with the understanding that my work will be used only for research, publication and related academic purposes. I further understand that granting or not granting this permission will not influence my grade for the course.

Name __________________________________

Date __________________________________