Acknowledgment Permission Form

Journal

Manuscript No.

First author

Title of work

Acknowledgment Permission:

Authors must provide written permission/approval from all individuals mentioned by name in the Acknowledgements section of a submitted manuscript. By signing this form, any and all acknowledged persons therefore state that they have read and approved the mention of their names in the Acknowledgment section of the aforementioned paper.

Printed Name

Signature

Date

Printed Name

Signature

Date

Printed Name

Signature

Date

Printed Name

Signature

Date