Rights and Permissions Request Form
The Harvard Crimson The University Daily Since 1873
RIGHTS AND PERMISSIONS REQUEST FORM Name: _____________________________________ Name of Organization: ___________________________________________ Brief Description of Organization: ________________________________________________________________________________ ____________________________________________________________________________________________________________ Mailing Address: ______________________________________________________________________________________________ City: ____________________________________ State: ______ Zip: _____________ Country: _______________________ E-mail Address: ___________________________________________________________ Preferred method of reply (please check one): Postal mail E-mail Fax Type of Material Requested: Article Photograph
Other, please specify: _________________________________________________
Publication in which requested material appears: Daily Crimson Fifteen Minutes Magazine Online Website Other, please specify: __________________________________________________________ Title of article under which requested material appears: _____________________________________________________________ ____________________________________________________________________________________________________________ Name of author(s), photographer(s) or designer(s) of requested material: ______________________________________________ ____________________________________________________________________________________________________________ Publication date of requested material: ___________________________________________________________________________ Nature of use (please check one): For-profit Not-for-profit (personal)
Not-for-profit (educational) Other, please specify: ______________________________________________________
Briefly describe how you intend to use the requested material (attach additional pages as necessary): Payment Information: Check enclosed (Make Payable to “The Harvard Crimson”) Charge my credit card: Visa MasterCard
American Express
Card no: (must be 13, 15 or 16 digits) Exp. Date/CCV: ____________ Name on Card: _______________________________________________________________________________________________ Credit Card Billing Address: _____________________________________________________________________________________
Terms and Conditions of Use * You must reprint the content exactly as it appeared in The Harvard Crimson (in print or online), together with all notices and legends, and include the notice “© 2014 The Harvard Crimson, Inc. All rights reserved. Reprinted with permission.” If you wish to reprint an excerpt or portion of Crimson material, you must use it exactly as described on the request form. * You may not assign or license your reprint rights to anyone without our prior permission. * This Agreement shall be governed by Massachusetts law, and any dispute relating to it must be brought only in the courts in or near Cambridge, Massachusetts.
By signing below, I agree to the above terms and conditions of use, which shall be binding upon my receipt of permission hereunder, I affirm that all information in this request form is accurate and true to the best of my knowledge. Signature: _______________________________________________________
Date Signed: ______________________________
RIGHTS AND PERMISSIONS REQUEST FORM Name: _____________________________________ Name of Organization: ___________________________________________ Brief Description of Organization: ________________________________________________________________________________ ____________________________________________________________________________________________________________ Mailing Address: ______________________________________________________________________________________________ City: ____________________________________ State: ______ Zip: _____________ Country: _______________________ E-mail Address: ___________________________________________________________ Preferred method of reply (please check one): Postal mail E-mail Fax Type of Material Requested: Article Photograph
Other, please specify: _________________________________________________
Publication in which requested material appears: Daily Crimson Fifteen Minutes Magazine Online Website Other, please specify: __________________________________________________________ Title of article under which requested material appears: _____________________________________________________________ ____________________________________________________________________________________________________________ Name of author(s), photographer(s) or designer(s) of requested material: ______________________________________________ ____________________________________________________________________________________________________________ Publication date of requested material: ___________________________________________________________________________ Nature of use (please check one): For-profit Not-for-profit (personal)
Not-for-profit (educational) Other, please specify: ______________________________________________________
Briefly describe how you intend to use the requested material (attach additional pages as necessary): Payment Information: Check enclosed (Make Payable to “The Harvard Crimson”) Charge my credit card: Visa MasterCard
American Express
Card no: (must be 13, 15 or 16 digits) Exp. Date/CCV: ____________ Name on Card: _______________________________________________________________________________________________ Credit Card Billing Address: _____________________________________________________________________________________
Terms and Conditions of Use * You must reprint the content exactly as it appeared in The Harvard Crimson (in print or online), together with all notices and legends, and include the notice “© 2014 The Harvard Crimson, Inc. All rights reserved. Reprinted with permission.” If you wish to reprint an excerpt or portion of Crimson material, you must use it exactly as described on the request form. * You may not assign or license your reprint rights to anyone without our prior permission. * This Agreement shall be governed by Massachusetts law, and any dispute relating to it must be brought only in the courts in or near Cambridge, Massachusetts.
By signing below, I agree to the above terms and conditions of use, which shall be binding upon my receipt of permission hereunder, I affirm that all information in this request form is accurate and true to the best of my knowledge. Signature: _______________________________________________________
Date Signed: ______________________________
