To:
Reference:
Date:
I am writing to request permission to reprint the following material from your publication:
Author/Title/Date of publication:
Pages as they appear in your publication:
Other identifying information and remarks:
This material is to appear as originally published (any changes or deletions are noted on the reverse side of this letter) in the following work that the University of Arizona Press is now preparing for publication:
Author (Editor)/Title:
Proposed date of publication:
Number of copies to be printed:
Binding type (cloth/paper):
Price:
Remarks:
We request nonexclusive world rights, as part of our volume only, in all languages and for all editions.
If you are the copyright holder, may I have your permission to reprint the above material in our book? If you do not indicate otherwise, we will use the usual scholarly form of acknowledgment, including publisher, author, title, etc.
If you are not the copyright holder, or if additional permission is needed for world rights from another source, please so indicate:
Thank you for your consideration of this request. A duplicate copy of this form is enclosed for your convenience.
Sincerely yours,
The above is hereby approved on the conditions specified below, and on the understanding that full credit will be given to the source
Date:_________________. Approved by:___________________________________________