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+Please email the following information to fsf-records@gnu.org, and we
+will send you the assignment form that covers your program.
+
+Please use your full legal name (in ASCII characters) as the subject
+line of the message.
+
+
+[What is the name of the program or package you're contributing?]
+
+
+[Will this become part of a larger GNU package?  If so, what package?]
+
+
+[Did you copy any files or text written by someone else into the
+program?  Even if that material is free software, we need to know
+about it.]
+
+
+[Do you have an employer who might have a basis to claim to own
+your changes?  Do you attend a school which might make such a claim?]
+
+
+[What country are you a citizen of?]
+
+
+[What year were you born?]
+
+
+[Please write your email address here.]
+
+
+[Please write your postal address here.]