Gallery10 Submission Form

Use Tab and Shift+Tab to move among the fields on this form, or click on the field you want to fill out. Date

Code Number

[gallery use only]

gallery 10 submission form

For best consideration, please submit both an electronic copy of your work and a hard copy of your work (with a copy of this form filled out). Hard copies should go to CoAS 205 or CoAS 211 or to your professor. Send the electronic copy of your submission to [email protected] in word format. If you only submit an electronic copy, state, in the body of the email, that you have read the submission guidelines and that you give us permission to publish your work in the magazine, should we accept it. Include reliable contact information with all of your submissions.

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Submission Information Under Genre are drop down menus from which you can select. For additional submissions, insert a duplicate table row or use additional forms. Genre

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PLEASE NOTE: All original works MUST be picked up by the end of the spring semester. You can pick them up at the office of Dr. Britt Haraway, CoAS 205.

Biographical Information for "Notes on Contributors" Don’t be shy; your audience would like to know about you. Name       Academic Classification Major       Interests and/or concerns      

Circumstances of your work’s genesis       How & when you began writing, got interested in photography, art, etc.       Something about you that readers will find interesting      

I would you be interested in doing a public reading/presentation of your work. I would you be interested in having your work published in a smaller, alternative format—i.e., a chapbook. I would you be interested in my work being published on a website.

The University of Texas-Pan American Consent Form PART I: I hereby forever release and discharge the University from any and all claims, actions and demands arising out of, or in connection with, the use of my works submitted to gallery, including, without limitation, any and all claims for invasion of privacy and/or libel. I waive any right or option to inspect or approve the finished product or any headline, title, or other copy which may be alongside such works, and I understand that written copy may be edited, and that graphics may be cropped or altered, or may not reproduce satisfactorily. I understand, that any publication of this work is within the sole discretion of the University, and that it could possibly not be used at all. This release shall inure to the benefit of the assigns, licensees, and legal representatives of the University. This consent and release covers first North American serial rights only; thereafter, all rights revert to me, the undersigned. PART II: a. I hereby request:  that my name not be used  that the following pseudonym b used with my work:        that my name be used as 'written on the front of this form b. I hereby represent:  that I am over eighteen years of age  that I have read this consent and understand its contents I,      , state that my submission (s) to gallery have never been published elsewhere.

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