I am preparing materials to be contributed to volume ________ of the Purdue Cytometry CD-ROM series:
To:_________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Publication: The Purdue Cytometry CD-ROM Series
Publisher: Purdue University, West Lafayette, IN, 47907
Approximate size: 3,000-7,000 files; 500-2,000 images
I request permission to include the material specified below in this and subsequent editions of the Purdue Cytometry CD-ROM. The CD-ROM series is an educational tool used for all levels of education in the field of cytometry. The CD-ROM contains text, images, audio and video material.
Specific information:
Book Authors/Editors:________________________________________________
Copyright date:______________________________________________________
Title of Book or Periodical:_________________________________________
Chapter or section title:____________________________________________
Author of chapter or section:________________________________________
Images:
Figure #__________ page #__________
Tables#__________ page #__________
Text:
Page #:__________ from line #:__________ Beginning with:_____________________
Page #:__________ to line #:__________ Ending with:__________________________
Requester's Name:___________________________________________________
Requester's Address:_________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
________________________________________________________________________
Authorised Signature
________________________________________________________________________
Title
____________________________________
Date
Copyright Notice as required:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________