PERMISSION REQUEST FORM

Thank you for seeking permission to reprint material from Crossroad / Herder & Herder / Convivium.

To protect copyright and to ensure that our authors are paid for re-publication and dissemination of their work, we require a Permissions Request to stipulate and validate the terms and conditions of use. Charges vary depending on usage.

Please submit the form below, and you will get an email from rights@crossroadpublishing.com.

Due to the high volume of permissions requests, the permissions process might take 2-4 weeks to complete.

Please follow up if you haven’t had a response within that time frame and if you have any questions, please contact us at rights@crossroadpublishing.com.

Contact Name *

Email Address *

Complete Title* *

Author *

ISBN (optional)

Excerpt length (word count and page number) *

Example 56 words page 20, 100 words page 50, 400 words page 130.

Total (words and excerpts) *

Example: 556 words/3 excerpts.

Total word count of your publication

Author of your publication

Title of your publication

Territory of your publication distribution ( North America, US, world, etc)

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Day

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Address Line 1 *

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website address

Excerpted material must be accompanied by a credit line with the following format :

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PERMISSION REQUEST FORM