To be completed for all submissions accepted for publication in The Meducator. 

By signing this form you certify that your contribution is your original work, has not been published before and is not being considered for publication elsewhere; that you have obtained permission for and acknowledged the source of any excerpts from other copyright works; that to the best of your knowledge your paper contains no statements which are libellous, unlawful or in any way actionable and that you have informed any co-authors of the terms of this agreement and are signing on their behalf. 

Please read the notes. Then print out the form and complete parts 1 and 2. If you do not own the copyright to your article, please complete part 1 and get the copyright holder to complete and sign part 3. Return the form to the address below and keep a duplicate for your records. 

If you wish, you may download a Word 97 or PDF (requires Acrobat Reader) version of the form. 
 

1	To be completed in all cases:

 
Name 
 

Address 
 
 
 

Article Title 
 
 
 
 
 
 
 
 
 

2	To be filled in if the copyright belongs to you:

 
In consideration of the publication of my contribution in the above journal, I hereby warrant: 

(a) 

that in the case of joint authorship I have been authorised by all co-authors to sign this agreement on their behalf, and references to the singular shall include the plural as appropriate; 

 (b) 

 that this article is the author(s)' original work, has not been previously published elsewhere either in printed or electronic form (including World Wide Web home pages, discussion groups and other electronic bulletin boards), and is not under consideration for publication elsewhere; 

(c) 

 that this article contains no violation of any existing copyright or other third party right or any material of an obscene, libellous or otherwise unlawful nature, and that I will indemnify and keep indemnified the Editor and Meducational Skills, Tools & Technology against all claims and expenses (including legal costs and expenses) arising from any breach of this warranty and the other warranties on my behalf in this agreement; 

(d) 

 that I have obtained permission for and acknowledged the source of any illustrations, diagrams or other material included in the article of which I am not the copyright owner. 
 
 
In consideration of the publication of my contribution in the above journal, I hereby assign to Meducational Skills, Tools & Technology (acting as agent for the owner of copyright in the journal where different) the present and/or future copyright throughout the world in any form and in any language (including without limitation on optical disk, transmission over the internet and other communications networks, and in any other electronic form) 

 
Signed 
 

Date 
 

(to be signed by corresponding or senior author on behalf of all authors) 
 
 

3	To be filled in if the copyright does not belong to you:

 
Please provide the complete and full title of the copyright holder. This will be printed on the copyright line on each page of the article. It is the author's responsibility to provide the correct information. 

(a) 

Name and address of copyright holder (if not the author) 

(b) 

The copyright holder hereby grants Meducational Skills, Tools & Technology Inc. non-exclusive rights to deal with requests from third parties in the manner specified in paragraphs 4 and 6 of the notes. 
 

Signed 

 
 
Date 

PLEASE RETURN ONE SIGNED COPY OF THIS FORM 
TO THE EDITOR: 

Dr. Kalyani Premkumar 
#205, 1640 - 16th Avenue NW 
Calgary, Alberta T2M 0L6 
Canada