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WILEY PERIODICALS INC. JOURNALS PERMISSION REQUEST FORM Date Wiley Permission Wiley Manuscript Page or Figure I am preparing an article for publication in a forthcoming issue of the journal which is published by John Wiley Sons Inc. Estimated publication date Approximate number of pages I request your permission to include the following material in this and all subsequent editions of the abovereferenced book in all media of expression now known or later developed and in all foreign language translations and other derivative works published or prepared by John Wiley Sons Inc. or its licensees for distribution throughout the world and also in versions made by nonprofit organizations for use by blind or physically handicapped persons. Appropriate credit will be given as provided below. Author s and/or editor s Title of book or periodical Title of selectionCopyright date From page line beginning with the words To page line ending with the words Figure on page Table on page If necessary attach continuation sheet Please indicate your agreement by signing and returning the enclosed copy of this letter to me. In signing you warrant that you are the sole owner of the rights granted and that your material does not infringe upon the copyright or other rights of anyone. If you do not control these rights I would appreciate your letting me know to whom I should apply. Thank you. Name Requestor s Return Address AGREED TO AND ACCEPTED Signature Title Credit and/or copyright notice. Appropriate credit will be given as provided below. Author s and/or editor s Title of book or periodical Title of selectionCopyright date From page line beginning with the words To page line ending with the words Figure on page Table on page If necessary attach continuation sheet Please indicate your agreement by signing and returning the enclosed copy of this letter to me. In signing you warrant that you are the sole owner of the rights granted and that your material does not infringe upon the copyright or other rights of anyone. In signing you warrant that you are the sole owner of the rights granted and that your material does not infringe upon the copyright or other rights of anyone. If you do not control these rights I would appreciate your letting me know to whom I should apply. Thank you. If you do not control these rights I would appreciate your letting me know to whom I should apply. Thank you. Name Requestor s Return Address AGREED TO AND ACCEPTED Signature Title Credit and/or copyright notice. Appropriate credit will be given as provided below. Author s and/or editor s Title of book or periodical Title of selectionCopyright date From page line beginning with the words To page line ending with the words Figure on page Table on page If necessary attach continuation sheet Please indicate your agreement by signing and returning the enclosed copy of this letter to me. In signing you warrant that you are the sole owner of the rights granted and that your material does not infringe upon the copyright or other rights of anyone. If you do not control these rights I would appreciate your letting me know to whom I should apply. Thank you.

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