Licensing Form
Personal Details
First Name
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Surname
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Institution/Company Name
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Address Line 1
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Address Line 2
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Town/City
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County/State
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Postcode/ZIP
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Country
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Email Address
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Phone Number
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VAT Number
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Your Reference
Please insert here your Purchase Order number or any other reference
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Company/Charity Number
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Are you a student or member of staff at Cambridge University?
Are you ordering for or on behalf of Cambridge University Press?
Is this a renewal application?
Item Details
Item: Title
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Item: Author
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Item: Volume
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Item: Classmark
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Item: Description
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Item: Type
Item: Page/Folio Range(s)
Separate distinct ranges with a comma. For a whole work, use "All"
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Item: total images
The total number of images from this item that you want to license.
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Item: Image Order Reference
The Imaging Request number you received from us when you ordered the image or the date when you ordered it from Imaging Services.
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Item: Notes
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Licensing Details
Please fill in all sections below that apply.
Licensed Languages
Licensed Area
For unrestricted internet use and international travelling exhibitions select World
Print Publication
Print licenses are for one edition only. A separate application should be made for subsequent editions. If images are additionally appearing in electronic equivalents or associated editions, please also fill in the Notes field below.
Print Publication: Title
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Print Publication: Author
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Print Publication: Publisher
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Print Publication: Image size on page and Placement
Please use quarter, half, full, or double-page, and specify if the image is used inside or on the cover. For multiple images of varying size, use Other here and give details in Notes
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Print Publication: Date of publication
Use an approximate date if exact date is not known
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Print Publication: Expected print run
If not know, use Unknown here and provide details in Notes
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Print Publication: Publication type
If you choose Other, please provide details in Notes
Print Publication: Notes
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Electronic Publication
Use this section for Ebooks, Ejournals and online subscription magazines as well as all other online and electronic uses.
Electronic Publication: Title
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Electronic Publication: Author
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Electronic Publication: Publisher
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Electronic Publication: Edition
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Electronic Publication: Image size on page
Please use quarter, half, full, or double-page. For multiple images of varying size, use Other here and give details in Notes.
Your answer
Electronic Publication: Image resolution
e.g. 300 dpi, 150 dpi. Use Unknown if not certain.
Your answer
Electronic Publication: Date of publication
Use an approximate date if exact date is not known.
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Electronic Publication: License Period
For material to be deposited in institutional repositories (i.e. Electronic Theses) choose Other and enter Repository in the Notes field
Electronic Publication: Publication Type
If you choose Other, please provide details in Notes.
Electronic Publication: Notes
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Film/Broadcast Media
These licenses cover unlimited transmission of a 'flash' use of 10 seconds or less
Film/Broadcast Media: Title
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Film/Broadcast Media: Production Company/Commissioning Broadcaster
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Film/Broadcast Media: Release Date
Use an approximate date if exact date is not known
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Film/Broadcast Media: License Period
If you choose Other please give details in Notes
Film/Broadcast Media: Streaming?
Will the footage also be streamed on the internet i.e. iPlayer, More4?
Film/Broadcast Media: Production Type
For additional tie-in products such as merchandise, web use, accompanying book etc. please provide details separately in relevant section.
Film/Broadcast Media: Notes
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Exhibitions
Use this section for images to be shown as part of an exhibition itself. For exhibition merchandise use Merchandise, for exhibition catalogues use Print Publication
Exhibition: Title
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Exhibition: Institution
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Exhibition: Start Date
Use an approximate date if exact date is not known
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Exhibition: Duration
Licenses are for a maximum of 10 years
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Exhibition: Size of reproductions
e.g. A1, A2, A3, A4, A5. If multiple reproductions of varying size, use Other here and enter details in Notes
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Exhibition: Number of reproductions
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Exhibition: Admission Charge?
Exhibition: Notes
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Other
Use this section only where not covered by other sections above.
Other: Description
Please supply as much information as possible about your intended use
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