Use this form to give consent for Amherst College Library to consider displaying your poem in an electronic format on the main floor of the Robert Frost Library. Each author of a Work must submit a separate Consent Form.

Suggested poems must be free of copyright restrictions (i.e., in the public domain or contributed by their author). Typically they are displayed for 24 hours.

Questions regarding the Poetry Display or this Consent Form may be directed to the Librarian of the College:

Bryn Geffert, Librarian of the College
Amherst College Library
61 Quadrangle Drive
Amherst, MA 01002-5000

The Agreement
This an agreement between the author, whose name is entered on this form, below, and the Amherst College Library concerning the Work written by the Author, whose title is entered on this form, below. In the event a Work has multiple authors, each author must submit a separate form.

Author's Grant of Rights
The author grants to the Amherst College Library a non-exclusive license for use of the Work in the Library’s electronic poetry display. The Library shall include a notice on the Work saying "Copyright [Author's Name]."

Author's Ownership of Copyright
Copyright in the work remains with the author.

Warranty of Authorship
The Author warrants to the Library that the Work is original and that he/she is the sole author and has the full power to make this agreement. The Author indemnifies the Library against any losses and other expenses, including reasonable attorney's fees, after final judgment of any claim or action against any of all of these warranties.

By completing and submitting this form, the author accepts and is bound by this Agreement.

Please type your name here. A separate form must be submitted for each author.
Please enter the title of your poem.
Please type your postal address.
Please type or paste your work into the space below before submitting this form. For best results, include hard line breaks where appropriate.

Enter the characters shown in the image or use the speaker icon to get an audio version.