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Copyright Permission Request Form

Copyright Guidelines 

Please fill in all required fields. They are necessary to process your request.

*Required fields are in bold.

Requestor's Information

*Name
 

*Title:
 

*Organization:
 

*Address:
 

 

*City:
 

*State:
 

*Zip:
 

*Phone:
 

Fax:
 

*Email:
 

Publication Information

*Publication:
 

*Article Title:
 

*Citation:
 

*Date:
 

*Pages:
 

Use Information

*What are you using it for?
 

*Number of Copies
 

*When do you need an answer?