Copyright permissions
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Requester contact information
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Name
Company / Organization
Address
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Copyrighted material intended to use
Please provide as much detail concerning the copyrighted materials you desire to use.
Title of copyrighted material
Author
Publisher / Imprint
Publishing / Copyright year
What do you desire to use?
Kind of material
Describe in detail the material you desire to use (state the excerpt, video, text, song, image, etc. Add links if helpful.)
In what medium will you use the copyrighted material?
Describe in detail how you will be using the copyrighted material or what rights you seek.
Will you generate revenue from using the copyrighted material? (If yes, please explain in "Other".)
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