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Book 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:

Crossway product that contains the artwork:
Author:
Illustrator:
Number of illustrations you wish to use:
Page reference(s):

Select appropriate use:
Description of event:
Detailed desciprition of how artwork will be used:
Format in which artwork will be distributed:
Number of print copies:
List all digital distribution channels:
Provide journal/magazine name:
Title of article:
Length:
Check box if the journal/magazine will be sold:
Provide retail price:
Provide detailed description of intended use:

Check box if you will need artwork files:	Depending on the size of this request, fees may apply.