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