Permissions Request Form - Macmillan Publishers (original) (raw)

For disability inquires email: [email protected]

PERMISSION REQUESTS TAKE APPROXIMATELY 8-12 WEEKS TO PROCESS

Please note that we receive a high volume of requests on a daily basis. While we try our best to process requests within 8-12 weeks from receiving your request, we cannot guarantee this timeframe.

While we understand that some fields may not apply to your particular use, to help us more quickly process your request, we ask that you fill out the form to the best of your ability and make note of any circumstances in the Special Instructions section.

Fields marked with an asterisk * are required.

Macmillan Title Information

Publisher *

Title *

Author *

ISBN

Selection / Page Source of Excerpt *

Word count / Page count / Number of Illustrations / Line Count (please specify) *

Proposed Use of Work *

(If possible, please provide the material in context from your manuscript or book)

Upload Use of Work (max. file size 2MB)

Drag & Drop Files, Choose Files to Upload

Your Publication Information

Title *

Author *

Publisher *

Market *

List Price

Page Count

Anticipated Publication Date *

Format (select all that apply) *

Hardcover
Paperback
E-book
Test
Electronic Reserve
Custom Publication
Magazine
Non-dramatic reading/read aloud
Prop/set dressing
StoryWalk

Total print run/number of users *

Additional notes on print run/number of users (please provide breakdown by format if available)

Term (years) *

Distribution Territory *

If other please specify

Language *

If other please specify

Licensee (Entity that will appear on License) *

Licensee Mailing Address (Physical/Post) *

Requester Contact Name *

Requester Role *

Requester Contact Phone

Requester Contact Email *

Special Instructions

Please indicate any additional information that will help up process this request, including school name, course name, course duration, instructor, number of students, clearing house, licensing coordinator, etc.

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