Licensing Request Form

Audio/video clips and images for commercial and non-commercial use

The Licensing Request Form is not an order form. It only provides us with the basic information about the proposed use of the material which allows us to inform you about the licensing terms and conditions.

Note

Payment by bank transfer, GooglePay or PayPal (including credit card, debit card, and bank transfer).
With the purchase our Terms and Conditions are accepted.

Full Name

Institution / Company

Street Address

City / Town

Zip / Postal Code

State / Province

Country

Telephone / Mobile

Email

Billing Address (if different from above)

Nature of Project

Commercial (for profit)

Non-commercial (not for profit)

End user / Client

Number of images / clips

Image / Clip ids, comma delimited

USAGE

Type of Publication

Other

Reproduction Size

Reproduction size in cm/inch, comma delimited

Circulation (number of published / print run)

Geographic Distribution (Country, Countries, Region)

Language(s)

Rights (One-time, Time period, Other)

Other Uses

Special Instructions or Comments

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Note: Please fill out the fields marked with an asterisk.

Licensing Request Form

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