RECORD OF DISCLOSURE

TO: Earthdawn Journal, a licensee of FASA Corporation, in care of Andrew
W. Ragland, Editor, 343 21st Street NW, Cedar Rapids, Iowa 52405, U.S.A. 

I wish to submit for your consideration, subject to all of the conditions
below, the idea or item described in the section provided below. I am the
sole and exclusive owner (or the authorized representative [parent, agent,
etc.] of _________________________________, the owner) of said item or idea
and am of legal age and free to make agreements relative to the submission
of this idea or item. 

I understand that the term Earthdawn Journal as used throughout implies the
involvement of FASA Corporation, as Earthdawn Journal is a licensee of FASA
Corporation, and all materials approved by the editor of Earthdawn Journal
are passed on to the Earthdawn line developer at FASA Corporation for
second-level approval.

TITLE AND DESCRIPTION OF ARTICLE OR ARTWORK:

___________________________________________________________________________

I submit my idea or item voluntarily and on a non-confidential basis, and I
understand that this submission by me and its acceptance by Earthdawn Journal
does not, in whole or in part, establish or create by implication, or otherwise,
any relationship between Earthdawn Journal and me not expressed herein. I
further understand and agree that Earthdawn Journal, in its own judgement, may
accept or reject my submission and shall not be obligated to me in any way,
with respect to my submission, until Earthdawn Journal shall, at its own
election, enter into a properly executed written agreement with me, and then
only according to all of the terms of said agreement. If no agreement is
concluded, I shall rely solely upon such rights as I may have under patent,
copyright, and trademark laws. I agree that Earthdawn Journal may have a
reasonable period in which to consider this submission. If my submission has
been in tangible format as opposed to electronic, I wish Earthdawn Journal to
return the submitted material to me when consideration has been given to this
submission, and will provide sufficient postage with my submission for this
purpose, but will not hold Earthdawn Journal responsible for items or materials
which are accidentally damaged or lost. I understand that it is in my own
interest to retain a copy of all materials submitted. I further understand that
the acceptance by Earthdawn Journal of this disclosure does not create or
imply: (a) any financial or other obligation of any kind on the part of
Earthdawn Journal; (b) any confidential relationship or guarantee of secrecy;
and (c) any recognition or acknowledgement of either novelty or originality.
I agree that Earthdawn Journal may photograph, photocopy, or otherwise
reproduce, for its own records only, any material submitted by me herewith or
subsequently with respect to said idea or item, whether accepted or rejected.

PLEASE PRINT

Signature:_______________________________________________________
Name:_________________________________________Date:______________
Address:_________________________________________________________
City:__________________________________ State:______ Zip:________
Telephone:_______________________________________________________
Country:_________________________________________________________
Social Security Number: _________________________________________