diff --git a/conservancy/assignment/forms.py b/conservancy/assignment/forms.py
new file mode 100644
index 0000000000000000000000000000000000000000..1f69062fb394a5970f42dbccbc7aa12c68d5a422
--- /dev/null
+++ b/conservancy/assignment/forms.py
@@ -0,0 +1,73 @@
+import datetime
+
+from django import forms
+from django.core.validators import ValidationError
+from django.utils import timezone
+
+from .models import Assignment
+from .terms import TERMS
+
+
+def validate_in_past(value):
+    # Adding a day to allow the current date anywhere on earth, regardless of
+    # the server timezone.
+    if value > timezone.now().date() + datetime.timedelta(days=1):
+        raise ValidationError('Enter a date in the past')
+
+
+class AssignmentForm(forms.ModelForm):
+    period_begins = forms.DateField(
+        label='Assign the copyright in my above contributions starting on',
+        help_text='You can use the day you first started contributing (or, equivalently, your date of birth), or any later date.',
+        required=True,
+        widget=forms.DateInput(attrs={'type': 'date'}),
+        validators=[validate_in_past],
+    )
+    period_end_type = forms.ChoiceField(
+        label='and ending on',
+        choices=[
+            ('all future contributions', 'all future contributions (no end date)'),
+            ('a specific past date', 'a specific past date (specify below)'),
+        ],
+        widget=forms.RadioSelect(),
+        initial='all future contributions',
+    )
+    period_ends = forms.DateField(
+        label='Specific past date (if applicable)',
+        required=False,
+        widget=forms.DateInput(attrs={'type': 'date'}),
+        validators=[validate_in_past],
+    )
+    agreement_terms = forms.CharField(
+        widget=forms.Textarea(attrs={'readonly': 'readonly'}),
+        initial=TERMS,
+    )
+
+    def __init__(self, *args, **kwargs):
+        super().__init__(*args, **kwargs)
+        self.fields['attestation_of_copyright'].required = True
+
+    class Meta:
+        model = Assignment
+        fields = [
+            'full_name',
+            'email',
+            'country_of_residence',
+            'repositories',
+            'all_emails',
+            'period_begins',
+            'period_end_type',
+            'period_ends',
+            'agreement_terms',
+            'attestation_of_copyright',
+        ]
+
+    def clean_period_ends(self):
+        period_begins = self.cleaned_data.get('period_begins')
+        period_ends = self.cleaned_data.get('period_ends')
+        period_end_type = self.cleaned_data.get('period_end_type')
+        if period_begins and period_ends and period_begins > period_ends:
+            raise ValidationError('End of period is before start')
+        if period_end_type == 'a specific past date' and not period_ends:
+            raise ValidationError('This field is required')
+        return period_ends