Paper Number (assigned by the Publisher):

The Work (title and brief description of the paper or other contribution submitted):

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If the Author is the Owner of the copyright in the Work then, where used below, "the Owner" means the Author. If the Author does not own the copyright, state who the Owner is (giving name and address) and state why the Author does not own the copyright (e.g. the Author wrote the Work in the course of employment by the Owner):

1. In consideration of the AMSI and Collegium Basilea evaluating the Work for publication by the AMSI and Collegium Basilea (and publishing the Work if it so decides) the Owner grants to the AMSI and Collegium Basilea the exclusive right and licence throughout the world to edit, adapt, translate, reproduce and publish the Work in all formats, in all media and by all means (whether now existing or in future devised). Such licence is for the full term of copyright in the Work throughout the world (including all renewals, extensions and reversions). Such licence is freely transferable by the AMSI and Collegium Basilea and includes the right to sub-license.

2. The Owner warrants that:

(a) the Work is the original work of the Author and not copied (in whole or in part) from any other work or matter or (if the Work includes copyright works of persons other than the Author) the Work is substantially the original work of the Author and all necessary permissions have been obtained for use of such copyright works of such other persons.

(b) the Work has not been and will not prior to publication by the AMSI and Collegium Basilea be published.

(c) the exercise of the rights granted to the AMSI and Collegium Basilea by this Licence will not infringe the copyright of any person or result in any breach of confidentiality or the breach of any contract or of any law.

3. The Owner may reproduce/republish portions of the Work without seeking permission from the AMSI and Collegium Basilea, provided that any such republication is accompanied by an acknowledgment in the form:

(original citation) - reproduced by permission of the AMSI and Collegium Basilea

The Collegium Basilea will agree to any reasonable request submitted to it in writing by the Owner for republication of the whole Work, provided that the Owner ensures that any such republication is accompanied by an acknowledgement (in the above form) of first publication of the Work by the AMSI and Collegium Basilea.

4. If the AMSI and Collegium Basilea notifies the Owner in writing that it will not be publishing the Work then this Licence shall forthwith and automatically terminate (and all rights granted shall revert to the Owner).

5. This Licence shall be governed in all respects by Georgian and Swiss law.

SIGNED by the Owner or by someone duly authorised to sign for the Owner:

Signed: .......................................................... Name: .......................................... Date: ..................