The University of Arizona Press : Reprint/Excerpt in Electronic Media

Your reprint request may be submitted electronically by filling out and submitting this form, or you may print this page and mail or fax your request to:

Permissions Manager
The University of Arizona Press
Main Library Building, 5th Floor
1510 E. University Blvd.
P.O. Box 210055
Tucson, AZ 85721-0055
Fax: 520-621-8899
permissions@uapress.arizona.edu

Reprint/Excerpt in Electronic Media

ITEMS HIGHLIGHTED IN RED ARE REQUIRED

Name of Requestor:
Email Address:
Please note: We will only use your email address if we need to contact you about this request. We will not use it to send you unsolicited commercial email.

Address Line 1:

Address Line 2:

City:

State:
Postal Code: (enter NONE if not applicable)
Country:
Phone:
Fax:

Publication Information
Information on the work in which the material being requested will be used

Title:
Compiler:
Publisher:
Media:
(CD-ROM, Interactive video, etc.)

Price / Quantity: /
Publication Date:
mm/dd/yyyy format

Rights Sought: World Rights
Limited Rights:
Language of Publication:

Book Information

Title of Book:
The title of the U of A Press book for this request

Author of Book:
The author of the U of A Press book for this request

Title of Selection:
From the book (if applicable)

Author of Selection:
From the book (if applicable)

Page number(s):
Artwork Requested:
Table(s), figure(s), or other artwork(s)

Date Response Requested By:
mm/dd/yyyy format

Comments:

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