Permission for Publication in the BSU Writing Program On-line Anthology



Date  __________________



I give permission to the Boise State University Writing Program to use my writing titled



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in the on-line publication White Pine Review.    



Name (Printed)________________________________________________________  



Signature  ___________________________________________________________  



E-mail address ________________________________________________________



Address _______________________________________________________________



Class and section ______________________________________________________



Instructor’s Name _____________________________________________________ 



Instructor’s Signature__________________________________________________