Form for requesting permission to reproduce, reprint or translate WHO copyrighted material
* denotes mandatory field

Contact details
1) Title *
2) First name  *
3) Family name  *
4) Organization/affiliation *
5) Web site address
6) Type of organization *
7) If other, please specify
8) If STM signatory, please select
9) Position
10) Telephone *
11) Address *
Please provide complete business address with postal code
12) Country *
13) Email *

The e-mail format is "xxxx@yyyy.zzz"

Information about WHO material to be reproduced
14) Full title of WHO material from which the reproduction is to be made *
15) Website URL where WHO material is published *
16) ISBN / WHO Reference Number
17) Please select the item(s) to be reproduced *

To make multiple selections, press the "Ctrl key" and click on the items to choose.
Click to Select / unselect all
18) Type of reuse *

To make multiple selections, press the "Ctrl key" and click on the items to choose.
Click to Select / unselect all
19) No of item(s) to be reproduced *
20) For each item, please provide a reference and page number. If entire document, please state "Entire document". *

Information about your publication
21) Please provide the title of your publication that the above materials are to be published in *
22) Publishing format *

To make multiple selections, press the "Ctrl key" and click on the items to choose.
Click to Select / unselect all
23) Will you be translating? *
 No
 Yes, including English rights
 Yes, without English rights
24) If yes, please indicate languages
25) If web please provide URL / If other, please specify
26) Number of copies (if applicable)
27) Target audience and planned distribution *
28) Planned publication/distribution date *
29) If your publication or the material is to be sold, indicate the planned selling price or subscription fee *
30) Is your publication sponsored or funded by an organisation other than your own? *
Yes 
 No 
31) If yes, please provide additional information
32) Will there be any advertising associated with your publication? *
Yes 
 No 
33) If yes, please provide additional information
34) Subject(s) of interest that most correspond to your request *
35) Additional information about your request

Terms and conditions
1. This is a form to request permission and does not grant you a license to use the materials requested.
2. You do not have authorisation to use the materials requested unless and until your request has been approved by WHO. You will receive a notification by email within 5 working days confirming or declining your request.
3. If you are granted permission it will be pursuant to these terms and conditions. Please click in the box to confirm that you have read and understood the terms and conditions.

36) By submitting this request you confirm that you will abide by the terms and conditions if WHO grants you permission. *
 I have read and agree with the terms and conditions
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