MH International Permission Request Form

MH International Permission Request Form

Request Submission Date

“Licensee” Name*

Name of organization requesting permission

Licensee Address*

Licensee Contact Name & Email*

Book ISBN*

McGraw Hill Book ISBN

Book Author/Editor*

McGraw Hill Book Author

Book Title*

McGraw Hill Book Title

Book Edition*

McGraw Hill Book Edition

Content of Excerpts*

Chapter, excerpt page numbers from McGraw Hill publication

Permitted Copying Purpose*

Educational is non-commercial, Republication is for use in another publication, generally a commercial work by another publisher

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Course Name, Instructor, Semester

If permitted copying purpose is Educational, provide course name, instructor name, and semester(s) in which material will be used.

Author & Title of the Licensee's Publication

If permitted copying purpose is for Reproduction, please provide the author/editor & title of your publication.

Print Run*

Describe how the material will be distributed*

Type of contract

Is this a new request or a renewal of a previously issued license? If renewal, please attach a copy of original license.

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New Work Expected Publication Date*

Licensee anticipated publication date for Reproduction or semester start date for Educational

Languages*

Language Licensee is publishing

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Format Requested*

How the material will be distributed

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Distribution Territory*

Territory Licensee will distribute new work

Licensee Docusign Party

If different than requestor contact name & email

Copy of requested McGraw Hill material

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