ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <html> <HEAD> </HEAD> <body background="paper.gif" text="#9d2d28" link="#9d2d28" VLINK="#9d2d28" alink="#9d2d28"> <H3 align=center>Photograph Permission Form</H3> <P align=center>I authorize ________________________________________ to publish photographs, taken on _______________, of myself and/or my work, in print and electronic media including publication on any Society for Creative Anachronism, Inc. Recognized Internet web site, for any non-commercial purposes related to the SCA. This permission is given with no promise or expectation of anything of value in return.</p> <table border=1 width=100%> <TR> <TD>SCAdian Name (please print)</TD> <TD>Modern Name (please print)</TD> <TD>Modern Signature</TD> <TD>E-mail Address</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> <TR> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> <TD>&nbsp</TD> </TR> </table> </html>