PRINCETON UNIVERSITY PRESS
Permissions Department
Fax: 609-258-6305
41 William Street
Princeton, NJ 08540-5237
permissions@press.princeton.edu
 

REPUBLICATION PERMISSION REQUEST - Print & Electronic Media

Thank you for your request to reproduce copyrighted material from a Princeton University Press publication. In order to process your request, please complete this form in its entirety. Incomplete forms cannot be processed. If you send us your request via U.S. mail and a return fax number is not available, please include a stamped, self-addressed envelope. Please note that our grant of permission does not apply to any part of the material that is separately copyrighted. It is the responsibility of the Requester to determine, based on the credit lines or source notations listed in the book, the correct copyright source for the material.

1. Requester's Name: ______________________________________________________________________

Company Name: ___________________________________________________________________________

Address: _________________________________________________________________________________

City: ________________________________________________  State: ____________  ZIP: ______________

Country: ______________________________  Phone: ____________________  Fax: ___________________

E-mail: ___________________________________________________________________________________

2. I wish to use material from the following Princeton University Press book:

Author: ________________________________________________________  ISBN: ____________________

Title: ____________________________________________________________________________________

Copyright line from front of book: © ____________________________________________________________

Pages on which material is found (X-XX): _______________________________________________________

FOR TEXT: Total page count: __________ and Total word count: __________

FOR ILLUSTRATIONS: Total illustration count: ___________

3. The material will be used in the following publication:

Author: __________________________________________________________________________________

Title: ____________________________________________________________________________________

To be published by: ________________________________________ Publication date: __________________

PRINT FORMAT: Hardcover: __ Paperback: __ Length: _______ pp. Price: _______ Print-run: _______

Requesting nonexclusive _____ North American (or) _____ worldwide English language rights

ELECTRONIC FORMAT: Internet: __ Intranet: __ With password protection __

Site address: ______________________________________________________________________________

CD-ROM: __ Other medium: _____________________________ size: _______ price: _______

Number of copies in first pressing: _______ For course use, number of students: _______

If other format, state purpose: _________________________________________________________________

RETURN THE COMPLETED FORM TO: PERMISSIONS COORDINATOR at the address, email, or fax number above. Please allow 2-4 weeks for processing. Please refrain from calling to follow up unless more than 4 weeks have elapsed.