(Please check one of the following choices)
1. I agree that only my name may be mentioned in The Daniel Project or in any subsequent publication.
2. I agree that my name and the relation I had with Daniel Karthaus may be mentioned in The Daniel Project or in any subsequent publication.
3. I want to remain completely anonymous, only mentioned in the publication as 'someone who wishes to remain anonymous'
4. I want to be mentioned in a way that does not reveal my name, but my relation to Daniel, like 'a friend of Olaf', 'a church member', 'a professor at XYZ University', or similar. I would like to be mentioned as follows:____________________________
Name:_________________________________________________________ Address:________________________________________________________ email address:____________________________________________________ tel/fax number:___________________________________________________
Date and Signature:_______________________________________________ Please print this, and fax it to: Olaf Karthaus +81-123-27-6102