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Permission Request Form 1

The document is a permission request form for Nova Science Publishers to republish copyrighted or previously published work. It requests information about the original publication and graphics being reused and requires the signature of the copyright holder or publisher to grant permission.

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neutrini
Copyright
© © All Rights Reserved
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103 views1 page

Permission Request Form 1

The document is a permission request form for Nova Science Publishers to republish copyrighted or previously published work. It requests information about the original publication and graphics being reused and requires the signature of the copyright holder or publisher to grant permission.

Uploaded by

neutrini
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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www.novapublishers.

com
400 Oser Avenue, Suite 1600
Hauppauge NY 11788-3619, U.S.A.
Phone: (631)231-7269 Fax: (631)231-8175
Email: nova.main@novapublishers.com

PERMISSION REQUEST FORM


(FOR COPYRIGHTED OR PREVIOUSLY PUBLISHED WORK)

Date:

To:

From:

Permission is hereby granted to Nova Science Publishers, Inc. to reproduce in the upcoming Nova title
___________________________ its translations, if any, with worldwide distribution and in all formats, printed
and electronic, the graphics listed below from the original publication titled __________________________.

Original Publication

Author(s):

Title of Article/Chapter:

Title of Journal/Book:

Publication Year:

Number of Page(s):

Original Graphic:

Page Number(s):

Please include the signed permission form with the final draft of the manuscript. The manuscript submission is incomplete without it.
Please make sure to label the file correctly so we can identify it. Thank you for your consideration of this request.

I/we grant permission for the use requested above.

Name of Publisher or Copyright Holder:________________________________ Date:________________________

Signature of Publisher or Copyright Holder Representative: ______________________________________________

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