The MIT Press

Permissions Department
One Broadway, 12th Floor
Cambridge, MA 02142
Fax: (617) 577-1545 | Email: asatoh@mit.edu

Request for Permission to Republish MIT Press Material

Thank you for your interest in republishing journal content from The MIT Press. Please complete this form in full
and submit it by mail, e-mail, or fax.

A. Contact information:

Name:
Institution/Organization:
Mailing Address:
Mailing Address 2:
City:
State/Province:
Postal/Zip Code:
Country:
Email Address:

B. I wish to use the following material copyrighted by The MIT Press:

Book Title:
Chapter Title:
Author(s):
ISBN: Year of Publication:
Copyright line: ©
Material requested found on page(s):
Description of text passage(s):

Total Word count:

Total number of illustrations (figures, images, charts):
Identification of each illustration:
*please submit copies of illustrations requested

C. FOR REPUBLICATION USE:

Request reference code (if any):

Title of New Book/Journal:
Author(s)/Editor(s):
Title of Chapter/Article:
Anticipated Publication Date:
Initial Estimated Print Run:
Publisher:
Language(s) of publication:
Countries of Distribution:
If requesting use of an excerpt, please indicate if it will be used:
____As an epigraph _ ___Within text
____Other (please specify):
Will be published open access (Y/N):___If yes, OA license terms:_________________________
 Additional Information:
Licenses sought by format and pricing & sales projections
Format Click boxes U.S. Price Lifetime Sales,
below
est.
Hardcover
Paperback
Book club
Audio recording
Electronic text-storage media, not database
Electronic database (multiple works combined)

Please describe any other intended formats including pricing and anticipated units disseminated. If
you wish to license content for an intranet, define the scope of the audience, access control
mechanism, length of time, and the address of the intranet.

D. FOR COURSE USE:

Request reference code (if any):
Institution/School:
Professor Name:
Course Name:
Course Number:
Semester to be Used:
Number of Students:_____________________________________________________________
The material be available in: ___Print
__ Format __ Electronic Format/Reserve
___Other (please specify):__________________________________________________________