for consideration to submit articles to the Brain Health Magazine
Name as you wish it to appear in byline
Email for Paypal payments
Mailing Address (street, city, state, zip)
Link to headshot (please use a professional or semi professional image ... no selfies)
Social media links (FB, twitter, Instagram, pinterest)
ONE sentence bio (ex: Amy is an author and TBI survivor located in St. Paul, MN)
If you would prefer to swap your payment for a longer bio with clinic/business name and website, please check this box (and be sure to create longer bio above)
Which topics are you most interested in writing for? (check all that apply)
Balance & Gait
1. I understand that my article becomes property of the Brain Health Magazine and Faces of TBI, LLC and will be copyrighted as such, and may be used in any way they see fit. 2. I attest that the articles I submit have not been published elsewhere and are original content created specifically for the Brain Health Magazine. 3. I agree that I will not publish my submitted articles elsewhere, other than on my own personal blog with a link back to the magazine. 4. I understand I will not be paid for any article unless it is published, and that submission of my article does not automatically mean it will be published. 5. I understand that my articles may be edited for length, grammar, clarity, and voice. 6. I hereby hold harmless and release forever discharge the Brain Health Magazine and Faces of TBI, LLC from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have reason of this authorization. 7. I hereby irrevocably authorize the Brain Health Magazine and Faces of TBI, LLC markets to edit, alter, copy, exhibit, publish, or distribute for purposes of publicizing the Brain Health Magazine programs or any other related, lawful purposes. In addition, I waive the right to inspect or approve the finished products, unless otherwise previously agreed upon., including written or electronic copy wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my photo/image/editorial/art. (TYPING OF YOUR NAME BELOW CONSTITUTES AS A VALID SIGNATURE).
Paste your submission below, including title
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service