The University of Arizona Press : Reprint/Excerpt Permission Request

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
355 S. Euclid Ave., Suite 103
Tucson, AZ 85719
Fax: 520-621-8899
permissions@uapress.arizona.edu

Reprint/Excerpt Permission Request

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:
Author:
Editor:
Publisher:
Binding: Cloth
Paper
Cloth and paper

Probable List Price
(Cloth / Paper): /
Probable Quantity
(Cloth / Paper): /
Publication Date:
mm/dd/yyyy format

Number of Pages:
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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