Title*

First Name*

Last Name*

Institute/Company*

Address*

Post/Zip Code*

City*

State/Territory:

Country*:

Telephone*

Email*

What type of material use would like to use.

Please select the type of publication*:

Book

Title

ISBN

Author(s)

Year

Pages

to

Chapter Number

Title of Chapter

Journal

Title

ISSN

Volume

Issue

Year

Pages

to

Author

Article Title

What type of content you would like to use(Select one type of following options)*

Quantity of material:

If using excerpts please provide a total word count:

Are you the author of any type of material of the lawarence press?*

Format in which material will be used?*

Are you translating the material in other language?*

If yes, Specify the translational language:

Please provide information of your proposed use of material:*

Any other information