Copyright Request Form

for using M.C. Escher prints

Contact info
Name of contact
Email
Fax number
Name of Company /Organization
Type of Organization	Company Non profit organization Private person Museum
Street
City
Postal code
State/Province
Country
Publication info
Title of publication
Author of publication
Type of publication
Print run
Where are prints used (i.e.Front page  / Cover)
Which language or country rights would you like to request
Prints info
Which prints would you like to use. Please also state in which format you wish to receive the print, either as Black & White photograph or as a Transparency.