Permission Request Form, Illustrated EPA Stack Test Methods, Graphics

Permission Request
Form

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Image File Permission Request
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Use this form to request permission to produce reproductions of an ActiveSET.org
illustrated EPA test method. If your request is accepted, ActiveSET.org will send you a
higher resolution graphic file suited for your purpose and deliver it to you
formatted in the file type you need (.ppt, .tif, .jpeg, etc.).

Note: The Image Files cannot be used on websites or any other Internet application.
ActiveSET.org retains this right exclusively.

Complete The Form, Then Click "Submit Permission Request"
FIELDS MARKED WITH " * " ARE REQUIRED

First & Last Name:

e-Mail Address:

Company Or Organization:

Address:

City:

* State: *

Area Code & Phone Number:

Website Address:

Or N/A

Type Of Business:

Other (Describe):

Government...
Educational
Professional Affiliation
Consultant

Which Illustrated EPA Test
Method Do You Want
To Use ?

(Enter The Test Method Number Or Description)

How Will You Use This
Image File?

Printed In A Book...
Printed In A Magazine Or Newsletter
Printed In A Catalog
Power Point Presentation
Other:

How Many Times Will You
Use The Image File?

For One Publication Only
Repeatedly For One Year
Repeatedly For Several Years

Will The End User Purchase
Your Application?

Yes
No, this is for display or lecture use only.

What Type Of File
Do you Need?

High Resolution Graphic File (.tif)
High Resolution Graphic File (.jpg)
Power Point File (.ppt)
Other:

How Will The Image
Be Reproduced?

Full Color. Greyscale. Black & White
Other:

Do You Agree To Mail
(2) Hardcopies Of The Final
Piece To ActiveSET.org?

Yes. No

Enter A Description Of Your Application, Comments, Or Special Needs:

Do you want to receive

ActiveSET.org's FREE Monthly Newsletter

Yes, Please Send "SET News!" To My e-Mail Address
No Thank You
Already A Subscriber

IMPORTANT:
Submitting this form does not constitute nor imply your permission request has been
approved. You must receive written, legal authorization from ActiveSET.org
for your use of the copyright protected images.