JewishGen, Inc. Museum of Jewish Heritage 36 Battery Place New York, NY 10280 Fax #: (646) 437-4328

This Agreement is between JewishGen, Inc., a 501(c)(3) non-profit corporation (“JewishGen”), and ___________________________________ (“Donor”) as donor of material to the following program which is circled:

*Database	InfoFile	JOWBR	Photos	*KehilaLinks	*Yizkor Book Translation
* requires Addendum for all previously published material

Type, print or attach description of your donation: ______________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

1. Donor Certification
Donor certifies that Donor has all rights necessary to donate the material to JewishGen including all applicable verbal or written permissions of others who supplied any portion of the material to Donor.  Donor understands that JewishGen will rely on this certification.  Where written or copyright permissions have been obtained, copies are included with this agreement.  In the event of a complaint regarding the material, JewishGen may remove the material from its servers until a resolution is achieved.

2. General Requirements
In conjunction with this agreement and for no additional consideration, the Donor hereby grants to JewishGen a non-exclusive perpetual right to use, publish or distribute the donated material.  The non-exclusivity of this grant means that the Donor retains all rights to such data or information and may use, publish or distribute such data or information in any way Donor chooses.  This grant may not be revoked after the date of this agreement.

JewishGen shall not make substantive changes to the donated information but shall be permitted to make editorial or format changes to meet JewishGen's standards for presentation and to ensure maximum exposure by integrating the donated material with other features available through JewishGen.

3. Donated Material
I understand that JewishGen will only be able to accept the material for publication on its server when a signed copy of this agreement has been received in our corporate office.  If this project is a “work in progress” all additional material will be donated to JewishGen under the same conditions as set forth in Sections 1 and 2 above.

DONOR:
Please complete the Donor portion; sign, date and attach any available additional forms as instructed by project manager or program coordinators.  Mail or fax to the corporate address above.  A signed copy will be returned for your records.

DONOR Name:	_______________________________________ (print legibly or type: First, Middle, Last Name)	JGID #: ______________
DONOR Signature:	_______________________________________	Date: ____________________
DONOR Address:	_______________________________________ (City, State, Province, Country, Postal Code)	Phone: ___________________
	_______________________________________	Email: ____________________

JewishGen, Inc. JewishGen, Inc wishes to thank you for your JewishGen-erosity in donating this valuable material to the programs and projects we provide.  Please consult your tax advisor for a determination of whether this donation constitutes a tax deductible donation to JewishGen, Inc., a 501(c)(3) non-profit corporation.  Your donation has enabled us to take one more step forward towards our mission …