Cocaine Anonymous - Story Submission

Online Submission

*** All fields must be filled in and all checkboxes must be checked before submission will be accepted.

TRANSFER AND ASSIGNMENT OF ALL RIGHTS,
TITLE AND INTEREST IN ORIGINAL LITERARY WORK
AND ACKNOWLEDGEMENT OF ORIGINALITY

(This form is intended for original material submitted to Cocaine Anonymous World Services, Inc. and
Cocaine Anonymous World Service Office, Inc., and must accompany all submissions in order for such material to be published.
All materials submitted become the property of Cocaine Anonymous World Services, Inc. and Cocaine Anonymous World Service Office, Inc.)

With this document, I, the undersigned Cocaine Anonymous (hereinafter referred to as “CA”) member, hereby grant permission to
COCAINE ANONYMOUS WORLD SERVICES, INC., a California corporation (hereafter referred to as “CAWS”) and
COCAINE ANONYMOUS WORLD SERVICE OFFICE, INC., a California corporation (hereafter referred to as “CAWSO”),
their successors, assigns, and those acting on their authority, to publish the attached material entitled or described as follows:

Description of Submission :

I further acknowledge and agree that:

1. I possess full legal capacity to exercise this authorization and hereby release CAWS and CAWSO from any claims by myself,
my successors, and/or my assigns regarding the attached material.

2. This transfer includes the assignment and transfer of any and all claims I may have to United States and foreign copyrights,
claims of authorship or origination.

3. I am the author of this work, i.e. this work is completely original and I have not used any third party source(s), in part or in whole,
to create this work unless said third party source or sources are given full credit within the body of this work and further that said third party
or parties have given written permission for said use, copies of which are attached hereto.

4. CAWS and/or CAWSO may change, modify or revise this work to whatever extent either or both deem necessary. I understand that,
if selected for publication, this material will be edited in keeping with CA's understanding of the Twelve Steps and Twelve Traditions.
Submissions will also be copyedited to ensure ease of comprehension and adherence to standard rules of grammar and punctuation
as well as current CAWS and CAWSO style guidelines. In addition, editorial staff may also substitute different words and/or revise
sentence structure for clarification. I further understand that this material may be retitled and/or reprinted in more than one CAWS or CAWSO publication.

By checking this box, you are acknowledging that you have read and agree to the release above and are entering your digital signature.

Name:

Address:

Phone:

Email:

Submission

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We regret being unable to offer links to non-C.A. sites, due to our longstanding tradition of non-endorsement of outside enterprises, whether related to our goals or not. While we are grateful for all links from other Web sites, we do not endorse any product, service or opinion offered by any outside organization.

NOTE ON "PDF" FILES...
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NOTE ON "FLASH" MOVIES...
These movies require the free "Flash player". Flash player is not endorsed by C.A. but is used as an Internet standard format for audio and video content on this website.

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