National Resource Center on LGBT Aging
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Permission to Reprint

SAGE and the National Resource Center on LGBT Aging

PLEASE NOTE: If you are sharing the work via Facebook, Twitter, linking to the piece from another website or other forms of social media, you do NOT need to fill out this permission request form. If you are intending to reprint the work in a journal, print publication, textbook, course curriculum or other formal works, reprint permission is required.

Thank you for seeking permission to reproduce copyrighted material from SAGE and the National Resource Center on LGBT Aging. In order to process your request, please complete the following form in its entirety. You must complete an individual form for every article that you are requesting to reprint. After submitting this form you will receive a confirmation notice that you have successfully submitted a copyright reprint request. After we receive your submission, you will be contacted as soon as possible, but in no event later than fifteen (15) business days regarding your request.

All fields are required except for organization.

Your contact information:
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The undersigned requests permission to reproduce material from:
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Date of publication: m/d/yyyy
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This material will be reproduced in the following way (please indicate one):
Reprinted in a work (e.g., textbook, journal, course curriculum)
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Publication Date: m/d/yyyy
Work to be distributed free of charge or at a cost of $ per copy.
Reproduced as freestanding material
Work to be distributed free of charge or at a cost of $ per copy.

The undersigned agrees to the following:

  • The following credit line will appear on the first page of the reprinted material:
  • Name of SAGE/National Resource Center publication, by Services and Advocacy for GLBT Elders (SAGE) and the National Resource Center on LGBT Aging. www.lgbtagingcenter.org

  • When material is produced, one copy must be sent to SAGE, 305 Seventh Avenue, 15th Floor, New York, NY 10001, Attn: Hilary Meyer, Director of the National Resource Center on LGBT Aging.
  • Reproduction will follow text exactly. No changes, deletions, or additions will be made without specific permission.
  • This permission does not include any grant of copyright matter obtained by SAGE and the National Resource Center on LGBT Aging from other sources incorporated in the material specified. No rights other than the reprint of the specified materials are conveyed in this permission agreement.

By submitting this request, I acknowledge that I have not been granted any rights to use, reproduce, reprint, and/or distribute the requested materials is expressly granted by SAGE and the National Resource Center on LGBT Aging.

By submitting this request, I agree to accept a non-exclusive, non-transferable, one time license to copy the requested materials should they be granted by SAGE and the National Resource Center on LGBT Aging, so long as each reproduction is correct, complete, and includes the required copyright statement, which must be clearly stated on the reprinted materials. I acknowledge that I will be contacted regarding my requests within (15) business days of receipt of my confirmation and will be informed at that time whether or not permission has been granted.

I acknowledge and agree that nothing in my request conveys any intellectual property rights or any other interests to SAGE and the National Resource Center on LGBT Aging's materials. I may not reproduce, distribute, sell, license, assign, transfer, or convey to any person, business, or corporation any of the requested materials provided by SAGE and the National Resource Center on LGBT Aging to me pursuant to this request. I agree that I will not at any time assert or claim any interest in, or do anything that may adversely affect the validity or enforceability of, any intellectual property right belonging to or licensed by SAGE and the National Resource Center on LGBT Aging by virtue of this request. I agree to indemnify SAGE and the National Resource Center on LGBT Aging from and against any and all claims, liabilities, expenses and damages, including reasonable attorney's fees, arising from or related in any way to SAGE and the National Resource Center on LGBT Aging's performance of its duties under this request or my unauthorized use of the requested materials.

Should the SAGE and the National Resource Center on LGBT Aging grant its consent, I acknowledge that the consent to copy granted is neither severable nor transferable to a third party. Any such attempted transfer shall be void and of no affect.

By submitting this request, I certify that I am authorized to submit this request and agree to the terms set forth in this Agreement.