Contact Information

First Name*
Last Name*
Company Name
Address
City

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Zip Code

Country

USA (840)

E-mail Address*
Phone Number*

Image and/or Video Information

Date by which you need image or video *

2024-8月 (08)-9 (09)

What type of image/video are you requesting from Evident? *
Link to an image/video: *
Image/video Description:*

How will the image/video be used? *

[ ]Web[ ]Publication[ ]Presentation[ ]Other

If other, please explain
Context in which the image(s) will be used *
Will the image(s) be altered or modified in any way (i.e., inclusion of descriptive labels, re-colored, cropped, etc.) *
If yes, how and why

For Publication Use

Name of author(s)
Title of publication
Chapter name
Name of publishing company
Address of publishing company

Anticipated publication date

2024-8月 (08)-9 (09)

Languages of publication
Format(s) of publication (i.e., print, digital, CD-Rom)

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