In order to grant a licence for reproduction we require as much detail as possible about the way in which you intend to use the image. Please fill in details regarding your proposed use of Tate artworks so we can quote you a price.

If you do not have the full details please make a rough estimate, being as specific as you can. That way, we can give you an accurate quote for the images you have selected and if necessary can revise the licence details at a later date.

All fields marked with ' ' are compulsory.

Images:
Artist's Name:
Title of Work:
Tate accession number
	Colour Black and white
Usage:
How do you propose to use the image? (Tick box as applicable)
Advertising Retail Editorial Corporate

Media:

What medium do you want to use the image in? (Tick box as applicable)

Apparel (caps) Apparel (general clothing) Apparel (t-shirts) Artists' reference Advert (billboard) Advert (tv) Advert (magazine) Advert (newspaper) Advert (event programme) Advert (insert) Advert (internet) Book (dummy use) Book (hardcover/retail) Book (paperback/retail) Book (picturebook/retail) Book (textbook) Book (academic/educational) Brochure (commercial) Brochure (CD-ROM) Bus panel Bus shelter Calendar Catalogue CD-ROM Computer network (intranet) Computer programmes & games Credit cards Diary DVD Display (commercial) Display (non-commercial/ free entry exhibition) Internet Internet (educational/ academic: free to access) Internet (educational/ academic: subscription based) Presentation/PowerPoint Gift box Gift wrap Greeting cards Hang tags/Garment tags Jigsaws Lecture (admission fee charged) Lecture (free to attend) Magazine (academic Journal) Magazine (consumer) Magazine (electronic) Magazine (trade) Magazine (CD rom) Newsletter (external) Newsletter (internal) Newspaper (national) Newspaper (regional) Newspaper (electronic) Note cards Packaging Packaging (software) Packaging (CD/DVD) Place mats Playing cards Point of sale Postcards Poster (educational) Poster (retail) Press kits (PR) Presentation Prints (educational study) Puzzles Report (commercial) Report (non-commercial) Screen saver Slide Show (PR) Slide Show (video marketing) Stamps Stationery (letterheads) Television (cable) Television (digital) Television (satellite) Television (terrestrial)

Region:

What territories/languages will the image appear in? One country, one language UK inc. N. America World rights, all languages

Image size:
What size will the image be used in relation to the final work? (Tick box as applicable)
-- N/A -- 1/4 Page 1/2 Page 3/4 Page Full Page Double Page 1/4 Screen 1/2 Screen Full Screen	Background A6 (105 x 148 mm) A5 (148 x 210 mm) A4 (210 x 297 mm) A3 (297 x 420 mm) A2 (420 x 594 mm) A1 (594 x 841 mm) A0 (841 x 1189 mm) AO (841 x 1189 mm) or larger
Placement:
Where will the image appear? (Tick box as applicable)
-- N/A -- Inside Inside cover Cover Front cover Back cover	Wrap cover Gatefold Chapter opener Navigation button Title page
Print Run:
If you are printing the image how many copies will be printed? (Tick box as applicable)
-- N/A -- Up to 3,000 Up to 10,000 Up to 25,000 Up to 50,000 Up to 100,000	Up to 250,000 Up to 500,000 Up to 1 million Up to 3 million Over 3 million

Licence period:
How long will the licensed reproductions of an image be in circulation? (Tick box as applicable)
-- N/A -- Up to 1 week Up to 2 weeks Up to 1 month Up to 3 months Up to 6 months Up to 9 months	Up to 1 year Up to 2 years Up to 3 years Up to 5 years Up to 10 years 10 years or more
Start Date:
When do you want the image licence to begin?
Industry:
In which industry will the licensed reproduction appear? (Tick box as applicable)
Airlines Art Automotive Baby/children Banking Beauty/Personal hygiene Beverages Communications/media Computers/Software/internet Department stores Education Electronics/Appliances Entertainment/TV/Film Fashion/Apparel Financial/Insurance Fitness Food Household products	Legal services Medical/Dental/Optical Music Non-Profit/Foundations Paper/Printing Pets Pharmaceuticals/Vitamins Photography Property Publishing Shipping/Freight Sportswear Sporting events Sporting goods Telecommunications Toys/Games Transport Travel/Tourism

End Client:
What is the name of the client using this licensed reproduction?
Description:
Please enter a brief description of the usage of the photo.
Your Details/make invoice payable to:
Name:
Address:
Telephone:
Fax:
Email:
VAT registration (EU Customers only):

How would you prefer to pay:

VISA/Mastercard    or     Cheque    or     BACS

Thank you. Please fax or post your completed form to us at the address below.
A member of Tate Images staff will be in contact shortly.

Tate Images
Tate Enterprises Ltd.
The Lodge
Millbank
London
SW1P 4RG

Fax: +44 (0)20 7887 8805