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Pollinger Limited
9 Staple Inn
Holborn
London
WC1V 7QH

Tel: 020 7404 0342
Fax: 020 7242 5737

 
Permissions

If you would like to use material from one of our clients’ books, please complete the details below. When you submit the form it will go to Permissions Manager. You will receive a permissions invoice in the post as soon as possible after we receive the information.

Fields marked with an * are only required if known
Details of Applicant

Your Name
Email Address

Phone Number

Company Name*
Address
 
 
Details of Book Being Quoted From
Title of book which material is taken
Author of book which material is taken
Publisher / Imprint*
Edition and ISBN (Please list both)*
 
Details of Extract
Is The Extract...

| Click here to give details
| Click here to give details
If Poetry:

Name Of Poem

Poet

Number of lines in extract

on page

Is this a complete poem?


 
If Prose:
Number of words in extract from page to
Is this a complete chapter or story?

If Illustration:
Title or caption of illustration(s)
Illustrator
Page number(s)
For reproduction in


   
For reproduction on cover or jacket
inside page
   
Size of reproduction
 
Details of Your Publication
Title
Author
Publisher / Publication Date* /
What format(s) do you require
permission for? 		Trade paperback Hardback
Mass Market Paperback Textbook
All Formats Required
Is the book..*



Other

Other Details Price 1st Print Run
(Approx if necessary)

ISBN* Page extent

Territories required
Languages
Context in which the quotation will
appear (Optional)
Any other information
e.g different billing address
(Optional)
   
 

 

 
 
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