Off-Campus Library Services
Central Michigan University



Form to Request Copyright Permission - Book Excerpt

Please provide as much information as possible to expedite your request.

Instructor:

Course #:

Title of book:

Author(s)/Editor(s) [please include first and last name(s)]:

Chapter Title:

Chapter Author(s) [please include first and last name(s)]:

Year/Edition:

ISBN:

Pages:

Publisher:


If this selection is excerpted from an anthology, state the title of anthology and year:

If material is taken from a web site, state the complete web site name and address:

If you would like a copy of this form enter your e-mail address: