1. Your Name: ______________________________
    
2. Organization: ______________________________
    
3. Telephone No: ______________________________
    
4. Email Address: ______________________________
    
5. Name of the graphic file (e.g. "Airplane.jpg"): __________________________
    
6. For each graphic file submitted provide a brief narrative description of the image (See Current & Prior "Image of the Months for examples) containing the following information:
   • Description of the scene content and context.
   • Items of special interest that the graphic illustrates.
   • Individual to Contact For Further Information to be published with the article on the Society Web Site:
     • Contact\'s Name: ______________________________
     • Postal Mailing Address: ______________________________
     • Telephone: ______________________
     • Fax: ______________________________
     • Email address: ______________________________
        
7. Submit the JPEG/GIF image as an attachment to this email message.
    
8. Include a permission statement granting the IMAGE Society royalty free license to publish the graphics file(s) on its web site as follows:
   

   [ John Doe -and/or- XYZ Corporation ] , as copyright owner(s) of the following graphics files: [ list the files e.g. scene1.jpg, scene2.jpg, scene3.gif, etc.] do hereby grant The IMAGE Society, Inc. royalty free license to publish said graphics files as "Image of the Month" (at its descretion) on its Web Site provided credit is given as specified in the attached "narrative description".

A new JPEG/GIF graphic will be selected from the submitted entries for each calendar month as the Site\'s Image of the Month.