ESV Artwork Permission Request Form

Name:
Email Address:	This is how we will follow up with you.
Address (street, city, state, zip, country):
Phone number:
Are you an individual or a company?
Company name:
Company website URL:

Select request:
Date of last permission:

Detailed description of Artwork that will quote the ESV

Product line type:
Number of unique products you plan to produce within product line:
Number of copies you plan to produce of each unique product:	Example: Scripture cards are one product line. If you have two different sets of scripture cards, you have 2 unique products in the product line. Provide number of copies you want to produce of each unique product – e.g. 200 of first set, 200 of second set.
Materials/media used:
Approximate size:
Approximate number of verses featured on each product:
What percentage of the product's total text will be from the ESV?
Check box if you plan to edit or revise the ESV text:
Explain:
Check box if this product will be sold:
List retail price:
Select requested formats:
List all distribution channels:

	Add another product line