Request Permission to Publish

Complete and submit this form to request permission to quote from or publish facsimiles of Special Collections materials.

All requests are subject to compliance with the provisions of U.S. Copyright Law and UC Library policy.

Your name

Your email address

Your telephone no. (enter as xxx-xxx-xxxx)

Your status

Material Description (Unpublished Materials)

Collection, Name/Number, Box Number, Folder Number, Other Identifying Information

How did you identify this item (onsite visit, online, etc.) Please provide URL:

Material Description (Published Materials)

Author, Editor, or Creator:

Title:

Publisher:

Date of Publication:

Other Information and Notes:

Brief Description of Material:

Description of Research

If your use is a non-educational, commercial use, please consult the Standard License Agreement Form. Uses necessitating a license will require the user to agree to the applicable terms described in this or a similar agreement.

Project Description

Publication

Please include title, and other known information:

Credit

The user will credit the UCLA Library in his/her publication. Credit should appear near the image or in a credits section of the publication, clearly marked with the page number that contains the image. Please consult the Research Library Department of Special Collections staff for the appropriate credit statement.