Polity Figure Permission Request Form

Figure Permission Request Form - Polity

If you are interested in using a text from a book published by Polity Press. Please complete and Print out this form and fax back to us with any additional information.

From which Polity book would you like to extract?

ISBN :
Author / Editor :
Title :
Year of Publication:
Figure & Page Reference:

Where would you like to include our material?

ISBN :
Author / Editor :
Title:
Rights Required :
Publisher :
Publication Date :
Print Run hb/pd :
Retail Price :

Note : If our material is to be edited or altered in any way please ensure that you supply a copy of the final material, as it will appear in your publication, with your request. If we are able to grant your permission you will receive our letter of permission and accompanying invoice in the post. Please allow up to four weeks for your request to be processed

Please provide your details:

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Name :
Title :
Department:
Position:
Institute / Company:
Street:
Town:
State / Province:
Zip / Postal code:
Country:
Telephone:
Fax:
E-mail:

YOUR DATA: We would like to contact you with relevant Blackwell Publishing and Polity new book and journal information in your subject area by mail, 'phone or email. This may involve the transfer of your data outside the EC. Your data may also be passed on within the Blackwell Group. If you do not wish to be contacted in this way, please tick here. mail phone email This may involve the transfer of your data outside the EC. Your data may also be passed on within the Blackwell Group. Please check this box if you do want your information used in this way.

Please return to:

Sarah Dodgson
Rights, Permissions and Translations
Polity
65 Bridge Street
Cambridge
CB2 1UR
UK
Tel: +44 (0)1223 370202
Fax: +44 (0)1223 461385
sarah.dodgson@polity.co.uk