Permissions Form

Shared by: HC12091406368
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posted:
9/13/2012
language:
English
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Document Sample
scope of work template
							McG Productions Ltd


Permissions Form
One form per author

Step One: Applicant details
 Name of applicant*          Click here to enter name
 Company                     Click here to enter company name
 Address of applicant*       Click here to enter address


 Email address*              Click here to enter email address


Step Two: Details of the work you seek permission to use
 Author*                     Click here to enter name
 Title of work*              Click here to enter title
 ISBN                        Click here to enter ISBN
 Number of words             Click here to enter number of words
 If poetry:                  Click here to enter title of poem
 Title of poem
 Number of lines             Click here to enter number of lines
 If illustration:            Click here to enter number of images
 Number of images
 Language (if not            Click here to enter language (Default English)
 English)


Step Three: Details of the proposed work in which the extract is to be
used
 Author*                     Click here to enter name
 Title of work*              Click here to enter title
 Publisher*                  Click here to enter publisher
 Publication date*           Click here to enter publication date
 Territory required*         Click here to enter territory
 Print run*                  Click here to enter print run
 Price*                      Click here to enter price
 If non-print work, select       Physical audio (e.g. CD) for commercial use
 appropriate format
                                Physical audio (e.g. CD) for non-commercial use
                                Digital audio (e.g. download, streaming) for commercial
                                use
                                Digital audio (e.g. download, streaming) for non-
                                commercial use
                                Photocopying
                                Braille/Moon
                                CD ROM/DVD ROM
                               Online
                             Specify website Click to enter website name or address
                                Other electronic
                                Musical setting
                                Performance
                                Prop in television/film production
McG Productions Ltd


Additional Notes

Please add any additional information relevant to the application
Click to enter additional notes




Completed forms should be sent by email to
permissions@mcgproductionsltd.co.uk

We will endeavour to process your request within 4 weeks.

						
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