THIS CONSENT FORM covers the performance described below.

Date of Presentation:

Presenter:

Introducer

Series:

Place:

Title/Topic:

Length:

Remarks:

I grant permission to Washington University to make an audio recording of the above presentation. I understand that this audio recording will be owned and maintained by the Washington University Department of Special Collections as part of its Modern Literature Collection for so long as the University believes said material to be of scholarly or historical value. The audio recording shall be preserved, organized, and made available for education and research in accordance with the University's Department of Special Collections access and use policies.

All rights in and to presenter's performance described herein shall remain the sole property of the presenter, and the rights granted herein are limited to archival, educational, and research, activities.