Wufoo
WAAN Submission Redistribution Agreement
Please complete this form to submit your original materials related to aging advocacy.
Name
*
First
Last
Date
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MM
/
DD
/
YYYY
I can be contacted at this e-mail:
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Title of your submission
*
Attach the file you wish to share.
*
I confirm that I am the creator of the material submitted.
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Yes
I request WAAN provide a credit reference to me for reproduction.
*
yes
no
Modification terms: I agree my work can be modified for reproduction under the following terms:
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Modification allowed with credit as follows: [My Name], modified by [First Last names of modifier].
Can be modified with no credit or reference.
No modification allowed.
I understand my submission may be posted by WAAN indefinitely and may be reproduced by other entities. I understand WAAN will include reproduction guidelines but has no control over the actions of other entities.
*
Yes
I understand that by submitting this form I agree to the terms identified above.
*
Agree
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