91��ý Rights and Permissions Request Form

91��ý

The 91��ý maintains an office of Rights and Permissions whose role is to process all requests for permission to use material published or produced by the Association. All requests should be submitted to the Rights and Permissions Office in writing or by submitting this form electronically.

Contact

Name

Affiliation

Department

Address

City

State

Zip Code

Country

Phone

Fax

E-mail

I hereby request your permission for the nonexclusive right to reproduce the following material from the 91��ý

1. Journal/Magazine

Author(s)

Volume

Issue

Issue date

Pages

Article title

2. Book title

Author(s)

Publication date

Pages

3. Other (please specify)

Please indicate the purpose of the material to be reproduced.

If the material will be included in a new publication, please supply the following information.

Title of book or periodical

Author/Editor’s Name

Publisher’s Name

Print Run (Books)

Price of Publication

please allow

91��ý

Please allow one to two weeks for processing.

Please address questions to:

Mary Jo Bolduc

Rights and Permissions

91��ý

225 N Michigan Ave, Suite 1300

Chicago, IL 60601

Telephone: 312 280-5416

Fax: 312 280-5275