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CONTACT DETAILS
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| Surname: |
| Forename(s): |
| Name of Company (if applicable): |
| Email: |
| Telephone Number: |
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Address:
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DETAILS OF THE BETWEEN THE LINES PUBLICATION TO BE USED
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| Title of Book: |
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Please clearly identify the passage or passages to be used, and specify the number of words involved.
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EXPLANATION OF HOW YOU WISH TO USE THIS MATERIAL (Publishers should give the title of their publication, its format, print run, price and the territories it is to be distributed in)
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Date: |
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Signature:
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Please post to Between The Lines, The Cottage, 14 Lyncroft Gardens, Ewell, Surrey KT17 1UR, UK, or fax to: +44 (0)20 8393 7055