Permission Request Form

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Full name *

Organization, Company or School Affiliation *

Email address *

Requested LFJ Material

Please tell us more about the materials you're requesting to reprint.

Title of the work you'd like to reprint *

URL of material *

Type of material *

Article

Publication

Lesson

Other:

Will you be reprinting the full text of the resource? *

Yes

If no, approximately what percentage of the text will you be reprinting?

Your Work

Please tell us more about where and how you'd like to use our materials.

What is the title of the publication or website where you'd like to reprint our resource? *

What is the medium? *

Website

Photocopied or shared electronically for use in a K-12 classroom

Other:

What is audience for the work selected above? *

K-12 educators

K-12 students

General public

Parents/caregivers

Higher education

Other:

Will there be a charge to access the material? *

Yes

If so, please explain:

Please estimate the number of people who will be reached by this reprint. (Number of copies, pageviews, etc.) *

Permission to republish does not constitute an endorsement from Learning for Justice. To republish, the following conditions must be met:

1) The content cannot be modified.
2) The title and author of the original must be cited.
3) No artwork or photographs may be republished, including the Learning for Justice logo.
4) If permission is granted, the following credit line must be included at the bottom of the page: “Reprinted with permission of Learning for Justice, a project of the Southern Poverty Law Center. [please include a link to the original here]."

Do you agree to the conditions above? *

Yes

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