I hereby acknowledge that Dr. Edward Vavra and/or Pennsylvania College of Technology have my permission to use for pedagogical or research purposes and/or publish any of the writing I have done in English 111. Such use may include, but is not limited to, 1.) publication in newsletters, pamphlets, or other collections published by the college or any department of the college, and 2.) publication in any article, book, or computer program written by Dr. Vavra. Such use is subject to the following restrictions: 1.) if the writing is to be used as an example of errors or other poor writing, the writing shall be used without my name. 2.) if the writing is used without any comment about its merit, or if it is used as an example of good writing, I (circle one: do do not ) want my name published with it. I understand that by signing this document my work may become part of a permanent file of student writing available to Dr. Vavra and to Pennsylvania College of Technology and that it may be used many years after I have left the institution.
Name (Printed) ________________________
Note: If you refuse to give permission to use your writing, PRINT your name at the top of this paper and hand it in without signing it. (This will give me a record of the fact that you were given the opportunity.)