LessThanFourTheBook.com

TIP: You may want to write your stories first in a file on your computer so you can edit them. When you're ready to submit, just copy and paste into this form.

First Name: *
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Address 1: *
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Name: *
Disability: (select below) *
Arm amputee
Leg amputee
Bilateral arm amputee
Bilateral leg amputee
Family Member
Other (Triple amputee, quad amputee, finger/toe amputee, etc)

What is your favorite amputee joke or funny story about being an amputee? (Maximum 300 words)

What is something you wish you knew before you became an amputee? (That is, a lesson you've learned, or something you've had to learn the hard way). (Maximum 300 words)

If you could give every amputee in the world one piece of advice, what would it be? (Maximum 300 words)

What is the hardest thing about being an amputee, and how do you deal with it? (Maximum 300 words)

Contact info (instant message name, email, LessThanFour username, etc)
(This is optional: Enter information below only if you want it published in the book so that readers can contact you)

YOU HAVE WRITTEN A STORY (the “work”) that may be selected by Joshua Sundquist (“the editor”) for publication in Less Than Four (“the book”). Your acceptance of these terms and conditions will constitute a transfer from you to the editor full ownership of all rights, titles, and interests, including the copyright, in and to the work.

FUTHERMORE, your acceptance will signify that you represent and warrant that you are the sole author and sole proprietor of all rights in and to all portions of the aforementioned work; that the work is original and not in the public domain; that it has not been previously published; that it does not violate or infringe on any personal or property rights of others, whether common law or statutory; that it contains nothing libelous or otherwise contrary to law of any country; and that you have full power to enter into this agreement. The authors will not be held liable in any way for any errors in the work relating to the aforementioned criteria or otherwise.

FUTHERMORE, your acceptance will also constitute your agreement that the work contains no material from other works protected by copyright that has been used without the written consent of the copyright owner, and that you have provided (or are simultaneously providing) the editor with copies of all such written consents required by this sentence.

YOU AGREE that this transfer of rights to the editor will occur without compensation to or from either party. The editor will hold the right to receive compensation from the sale of the book to a publisher or otherwise. Furthermore, the editor reserves the right to modify the work for style, clarity, content or otherwise at his sole discretion. You furthermore give permission for your first name, age and native country to be associated with the work.

YOU CERTIFY that you are legally able to enter into this agreement and that there are no laws preventing the agreement there of in your country or any other country. If you are of minor age, then your parent or guardian has agreed to these terms and conditions.