EmailMe Form - Licensing rights for #ArtePorUcrania anthology

PART 1: Name

Indicate the name or signature that you wish to use in the anthology.

Name or pen-name *

(Signature exactly as it will appear in the anthology)

Blog or website

(Blog, website or social media account that will appear below the signature in the anthology)

Twitter handle

Instagram handle

Profile picture *

I will send a profile picture

You must send a profile picture to arteydenuncia@gmail.com at a minimum size of 500 x 500 pixels.

Author profile (450 characters max.):

Write a brief profile mentioning your literary or artistic experience.

Will you send a high resolution image of your work? *

Yes, I have sent it

Yes, I will send it

No, my work has no images

For plastic arts works, a digital version must be sent in a high resolution image through a file transfer service to arteydenuncia@gmail.com.

PART 2: Non-Exclusive License Consent

Non-exclusive license consent granted by the author-owner of the author proprietary rights of a work

Data of the natural person who authorizes the use (hereinafter, the author-owner):

(These data will not be made public and will be protected by the licensee).

Name and last name *

First Last

Real name and surnames. You must indicate first name and middle name (if you have one). You must indicate all your legal surnames (These data will not be made public and will be protected by the licensee).

Gender *

Nationality *

Place of birth (city and country) *

City of residence *

Municipality/State/Province/Community or Department *

Country of residence *

Email *

Data of the natural person to whom the use is authorized (hereinafter, the licensee):

Name of the institution: Editorial Salto al reverso
Name and surname of the legal representative of the institution: Carla Paola Reyes
Gender: Female
City: Mexico City
State: Mexico City
Country: Mexico
Email: carla.paola.reyes@gmail.com

Through this non-exclusive license under the terms of article 30 of the Mexican Federal Copyright Law (published in the Diario Oficial de la Federación, on December 24, 1996, in Mexico), the author-owner authorizes the licensee so that she can:

I) Use the work(s) detailed below:

*

Write down the title of your work.

II) The expressly authorized uses are:
a) Publish it by editing it, including for this purpose its reproduction and distribution with or without profit through digital or printed copies, as well as public transmission in a digital format through computer networks, citing the source and the author.
b) Make available to archives, libraries, municipalities and other non-profit agencies copies of the work in printed and/or digital format.

III) The aforementioned uses will be remunerated with:
a) The provision of a copy in digital format for the author-owner who grants this non-exclusive license.

IV) The period for which the authorization is granted will be:
5 calendar years counted from the signing of this license.

V) This authorization is granted in the form:
Non-exclusive.
(The author-owner retains the rights to exploit his/her work by any other means and grant other authorizations to third parties).

VI) All royalties generated by this anthology will be donated to a charity that helps victims of the war in Ukraine.

By filling out this form, the author-owner authorizes their works to appear in the anthology #ArtePorUcrania / #ArtForUkraine of Arte y denuncia, published by Editorial Salto al reverso.

Name of the author-owner *

First Last

Real name and surnames. This name will be used in the official copyright record. You must indicate first name and middle name (if you have one). You must indicate all your legal surnames. (These data will not be made public and will be protected by the licensee).