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Permission Request Form

Please use this form to submit your request.

Personal Details
Permission Requests
(Note: We may contact you for copies of the specific materials)
Is this request for permission to translate?
If yes, please also complete additional Section II.
Is this request for permission to use materials in a book?
If yes, please also complete additional Section III.
Permission Requests - Section II (Translation Information)
For request to translate, please complete the following additional information:
Name of Language
Purpose of Translation
Name and qualifications of the individual(s) who will be conducting the translations:
Name and qualifications of a separate individual who will back-translate the materials for our review:
Qualifications of all individuals who will use the translated materials:
Where will the test be used?
How do you intend to ensure test security?
How do you intend to track the number of reproductions for reporting to us for billing purposes?
Additional Comments
Permission Requests - Section III (Publishing Information)
If for a book, please provide the following additional information about your product:
Title of your publication
Type of media (i.e., CD-ROM, print, etc...)
Publisher
Approximate date of publication
Additional Comments

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