HHJMQ Permission Request Form 1 Please complete this form, if you require permission for use of material from Hodder & Stoughton, Hodder Faith (including Bible text), Chambers, Teach Yourself (all titles), John Murray Press (including JM Learning), Headline Publishing Group, Quercus. APPLICANT DETAILS Applicant name* Company* Address* Invoice Address* (if different from above) Phone* Email* Today’s Date* REQUESTED MATERIAL Please check the cover, spine, and copyright page of the book. We are not in possession of file copies of all our books, and thus are unable to check this material on your behalf. Title of the book* Author/Editor* Publisher/Imprint* ISBN* (we categorically cannot process your request without this information) Publication date and Edition* HHJMQ Permission Request Form 2 WORD/LINE COUNT* FROM REQUESTED MATERIAL Number of words (prose only)* Line count (poetry/prayer only)* Page Reference* For recipes, please include name, and page number* Bible text Please check permitted free use limits here before applying for (please supply word and Bible text verse count for Bible text) https://www.hodder.co.uk/Information/Contact%20Us.page: Bible text continued * ( ) NIV Please delete as appropriate ( ) Today’s NIV ( ) NIRV Any other information which may help identify the material PROPOSED WORK IN WHICH THE EXTRACT IS TO BE USED (YOUR PUBLICATION) Your Publication Title* Your Author/Editor* Your Publisher* Formal permission is not required until you have secured a publisher Your territory for ( ) Throughout the World Distribution* (Please select ( ) UK and Commonwealth most applicable, and mark as ( ) USA and Philippines appropriate) If Other, please specify: Language* ( ) English If Other, please specify: HHJMQ Permission Request Form 3 FOR PRINT FORMAT PUBLICATION Your proposed publication date* Proposed price* Format (Hardback, Paperback) Your print run* Description of your publication* Context in which the material would appear* FOR ELECTRONIC FORMAT: WEBSITE URL where extract would appear* Company that runs your website Audio streaming or download? Can material be downloaded or printed? Length of time material will be available* Who can access it/ expected number of users* Restricted access/password protected? Territory for distribution. Please note: World Rights are required if you are posting anything online. We can only grant territories we control. Do they pay for access?* HHJMQ Permission Request Form 4 FOR ELECTRONIC FORMAT: EBOOK Title* Author* Price* First year download forecast* When you have provided as much information as possible, please email your completed form to [email protected]; alternatively send it to: Permissions Administrator Hachette UK Carmelite House 50 Victoria Embankment London EC4Y 0DZ NB: We receive a high volume of requests, thus the projected turnaround is 8 weeks, from receipt of the completed permission request form (possibly longer, depending on the complexity). Please take this into consideration, and apply in good time. We ask that you avoid sending duplicate requests, upon confirmed receipt. Under no circumstances are you entitled to assume consent, on the basis of not having received a response within our or your own specified time frame, and no exceptions can be made to account for any pending print deadlines you may face. Your patience is sincerely appreciated during this process. .