Subsidiary Rights Request Form

Please provide the following information. Required fields are indicated in red.

Contact Information:
Best Method of Contact: Mail     E-mail     Phone
Name:
Job Title:
Company/University Name:
Department:
Address 1:
Address 2:
City:
State/Province:     Zip/Postal Code:
Country:
Email:
Email (please re-type):
Phone:
Penn State University Press Publication Information:
Title:
ISBN/ISSN:
Author(s)/Editor(s):
Volume/Issue/Edition Number:
Year of Copyright:
Title of Article:
Figure or Table number(s):
Specific Page Number(s):
Information about your Forthcoming Work:
Title:
Author(s)/Editor(s):
Publisher:
Date of Publication:
Print Run (Hardcover):
Print Run (Paperback):
Price:
Total Pages and Word Count:
Rights Requested:
Comments/
Additional Information:
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