Consent Form To Use Student Writing

Student Writing Permission Form
Fall 2010 DSC 101—section Q, “Food as Muse”

Dear DSC 101 Students,

I learn by teaching and by talking and writing about my classroom experiments and experiences. You haven’t written anything for this class yet, but I’m asking in advance for permission to quote from your work. Your decision—granting permission or not—will not affect your grade. In fact, I won’t know what you’ve decided until the end of the semester since peer mentor Bobbie will collect and hold these forms.

In December, we’ll pass back this form so that you can confirm or change your decision. There are several parts of this permission, including a choice about whether or not I should use your name.

I’m not sure yet how I might share your writing with other audiences. In person, in print, or on the Web, I might

  • show it to students, faculty, or readers as a model paper or an example of a writing principle,
  • quote a selection in a conference paper/presentation or an article,
  • include it in a textbook (nothing in the works at the moment), and/or
  • tinker with your writing as part of these projects.

I also may not use your work at all. Thanks.

Sylvia Whitman, instructor

Sylvia Whitman
does not have
permission to use my writing as outlined above.

My name:
Date: / /2010
My age:

_ You may identify me as the author. _first name only _first and last name

_ You may use my work, but not my name. (I may make up a name or cast you as a generic student.)

December—second look at this form

Please update your permission. If making changes, please circle your current preference.

_ I wish to add an exception. You may use my work, except for the following papers or selections:

Date: / /2010
My age:

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