On-line Application Form

(Please apply separately for each author whose work you wish to reproduce)

a) Individual or company to be invoiced (if a fee applies)

Name
Address  

Phone no
Fax no
Email address

b) Individual to whom formal letter should be sent (if different)

Name
Address

Phone no
Fax no
Email address

c) Details of the work in which the extract is to appear

Author
Title
Publisher
Territory required
Edition/s
(eg hardback, paperback, book club, audio cassette)
Estimated print quantity of each edition
Course (for photocopying)

d) Details of the extract you wish to reproduce

Author
Title(s)
Number of words of prose
Number of lines of poetry
(please list each poem separately)
Language
(if not English)

e) Non-print permission (click if applicable)

Audio Cassette/Recording for commercial use
(please note we can only give permission for straight readings by one voice)

Audio Cassette/Recording for non-commercial use, for the blind or physically handicapped
(please note we can only give permission for straight readings by one voice)

Braille/Moon

Photocopying

Electronic
CD Rom
Closed website
Open website

Musical setting (composer)

Musical setting (publisher)