Author Assignment Form - International Journal of Community

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Assignment of Copyright and Authorship Responsibilities
The undersigned authors hereby affirm that the manuscript entitled:
“
”
under the reference number --- is original and that all the statements asserted as facts are based
on the author(s) investigation and research. The manuscript has not been published in any form
and is not being submitted for consideration or publication elsewhere, in total or in part, except
as an abstract of less than 400 words in the form of scientific presentations. The authors are also
requested not to submit the present manuscript elsewhere for a period of six months from the
date of submission to the International Journal of Community Based Nursing & Midwifery. If
the above requirements are not fulfilled, justification for duplicate publication and permission to
republish copyrighted materials must be declared and accompanied by a covering letter.
In signing this form, the authors acknowledge that they have participated in the work in a
substantive way and are prepared to take full responsibility for the data presented herein.
The author(s), in the event of the acceptance of the above manuscript for publication, does
hereby assign and transfer to that International Journal of Community Based Nursing &
Midwifery all of the rights and interests with respect to the above copyright either in its current
or any other form including revised or electronically disseminated versions.
All authors must sign: (Please mark the corresponding author)
Date
Name
Signature
1 __________ _________________________ _________________________
. ___
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______
2 __________ _________________________ _________________________
. ___
______
______
3 __________ _________________________ _________________________
. ___
______
______
4 __________ _________________________ _________________________
. ___
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5 __________ _________________________ _________________________
. ___
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Manuscript checklist
□ Cover letter
□ Assignment of copyright and authorship responsibilities (signed).
□ Corresponding author's address, phone number, fax number and email address on cover page.
□ An informative abstract of no more than 250 words.
□ Up to five keywords.
□ References in the appropriate format (numbers not exceed 40).
□ High resolution figures (jpeg format)
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