Copyright Request Form

Basic Contact Info
Your Name (required)
Your Email (required)
Your Telephone number (required)
What kind of Organisation are you?
Name of Company/Organisation (required)
Street & Number (required)
City (required)
Postal Code(required)
State or Province
Country (required)

 

Publication Information
Type of Publication
Title of Publication or Campaign (required)
Author of Publication or Organiser of Campaign (required)
Print Run and/or Frequency (required)
Where is the artwork to be used?
For which languages or countries would you like to request?

 

Promotional Campaign Information
Type of product to be promoted (required)
Medium(s) of Campaign (required)

 

Other
Please describe "Other" (required)
Please describe how the artwork is to be used (required)

 

Artwork Information
Title(s) of M.C. Escher art you would like to use (required)