Permission to Publish Form

[Below is the template permission to publish form used by Bibliotheca Alexandrina. This form is meant to protect the interests of both BA and the contributors. All contributors to BA anthologies are required to sign the form, or their works will not be used.]

Date: [insert]

From: [editor]

To: [contributor]

I am writing to request permission to use the following material/s sent to me: [title/s]

For use in the following work:

Title of Anthology: [title]
Author/Editor of Anthology: [name]
Publisher: Bibliotheca Alexandrina
Rights Requested: Worldwide, nonexclusive

Will you kindly give permission to reproduce the material/s indicated above in all editions and reprints of the work and any and all derivations thereof? Full credit will be given in whatever form you specify.

In signing below, you warrant that you are the sole owner of the rights granted herein, and that the work does not infringe upon the copyright or other rights of anyone. The rights you are granting are nonexclusive, which means that you still own this text and can use it as you will. It is understood that you waive all right to money derived from the authorized use of this material.


A .pdf of the manuscript will be sent to all contributors for their approval before the book goes to press. Any corrections to the submission must be sent to the editor within one week. The preview .pdf must not be distributed, and is for the contributor’s use only.

Legal name of contributor:  [insert]
Name to appear in print:     [insert]
Contact: [insert email address]

Authorized (e)signature:  [insert]
Date: [insert]

Contributor Biography (to appear in the anthology): [insert]

1 Response to Permission to Publish Form

  1. Greetings from London. I used to have a contact person for re-ordering your wonderful books. My hard drive was wiped, so I’ve lost my contacts. Could the person in charge of Bib. Alex. wholesale drop me a line? Thanks and good wishes, Christina at Treadwells Bookshop in London

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