Association for Encouragement

Association for Encouragement

of Children’s Creativity, Inc.

Permission to Publish

Date____________________

I am sending you my _____________________(story, poem, art) which I call

_________________________________________________________________.

I did this work myself and didn’t copy it from anyone or anything. You have my permission to print it in Magic Dragon magazine. My parent(s) or guardian(s) have signed below to show that you also have their permission to publish this work and to use it for related projects to support Magic Dragon.

I understand that if you publish this work you will identify me and give me credit as the author/artist, and that you will send me one free copy of the issue in which my work appears.

I understand that this work will not be returned to me unless I enclose a self-addressed envelope with proper postage.

Name – please print _____________________________________________________

Street _________________________________________________________________

City, State, Zip Code _____________________________________________________

Age____________________E-mail__________________________________________

Name of my school ______________________________________________________

My signature____________________________________________________________

My parent or guardian’s signature___________________________________________

Send your work to:

Magic Dragon

P.O. Box 687

Webster, NY 14580