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Permission Request

If you would like permission to reprint or photocopy material from any of our products, in print or electronic format, please complete the form below and click to Submit.

If you are a student who has a verified disability that prevents you from using standard instructional materials, please have your school's Disabilities Service Coordinator or other school official fill out this request and agreement for the electronic file you require.

Incomplete requests will not be processed.

* indicates a required field

* Book Title:
* Edition:
* Author:
* ISBN:
URL:

Ancillary Title:
Edition:
Author:
ISBN:
URL:

* Type of use:	Classroom Other

* Requested Material: ( including pages, illustration and figure numbers; chapters, pages, charts, photographs, and the page numbers on which they appear )

* Select the intentional uses for the material:
	Classroom handout CoursePack Republication Internet/Intranet CD-Rom Other:
Number of copies or units that will be reproduced, if any:

Will the textbook be adopted and students required to purchase the text or product for the course?
	Yes No


If the material is to be used online, please complete the following:
• URL where the content will appear:

• number of users who will access material:

• type of users who will have access (e.g. enrolled students, on-campus students, others):

• access to the information be restricted and password protected:
	Yes No If yes, explain how:
• downloading, printing, and copying will be restricted:
	Yes No If yes, explain how:


* Educator/Contact name:
* School/Company:
* Address:
* City:
* Province:
* Postal Code:
* E-mail:
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