Curriculum Studies Award Copyright Verification Form

Curriculum Studies Network Award Copyright Verification Form
THIS FORM MUST BE COMPLETED AND SUBMITTED BY ALL CURRICULUM AUTHORS.

This form provides NAGC permission to reproduce and distribute this curriculum for purposes of the award review process.
Curriculum Title
I am:
Please list the name, address, phone number, and email address of all curriculum authors.
Authors Name (yours)

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
I own/co-own the copyright and give NAGC permission to reproduce and distribute this curriculum for purposes of the award review process. I (we) understand that I (we) will not receive compensation from NAGC.
I own/co-own the copyright to this curriculum
By signing below, I verify that all the information contained in this nomination is true to the best of my knowledge.
Type Full Name Here
Date

MonthDayYear
Should be Empty:

Curriculum Studies Network Award Copyright Verification Form