Reprint Request Form

You must fill out the following form completely for your request to be processed. If information is omitted on this form, our permissions editor will have to contact you via phone, fax, or email before your request can be processed, and this may result in delays.

A written permission agreement will be mailed, faxed, or emailed to you within 90 business days.

Requestor's Information

Last Name:

First Name:


City: State:

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Country: Country Postal Code:

Telephone Number:

Fax Number:

Email Address:
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Information About Your Work (in which UMP material will appear)




Expected Month and Year of Publication:

Print Run (both hardcover and paperback):

Retail Price (both hardcover and paperback):

Rights Requested (e.g. English language, worldwide distribution, etc.):

University of Michigan Press (UMP) Book Information

Title of Book:

Author/Editor of Book:

ISBN (What is an ISBN?):

Year of Publication:

Page Number(s):

Tables, Figures, or Other Illustrations:

Comments/Additional Information

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