Request Licensing for an Image Please provide the details of your intended use so I can tailor a licensing agreement that works for your needs. Name * First Name Last Name Company Name Email * Phone (###) ### #### Image Title / Description * Intended Use * Editorial Commercial Advertising Corporate Educational Other Usage Details * Where/how the image will be used, geographic distribution, duration. Requested Duration of License * 3 months 6 months 1 year 2 years 3 years Perpetual Budget Range * $150 - $600 $600 - $1200 $1,200 - $1,800 $1,800 - $2,500 $2,500 - $5,000 $5,000 - $10,000 #10,000 - $20,000 $25,000 + Thank you!
