evaluation form
01
Full Name
02
Company
03
Phone
04
Email
06
Total # photos
needed
07
Photo ID #'s
08
Photo description
09
Usage type
 advertising corporate editorial nonprofit
10
End-user 's name
(your client)
11
Product
annual report brochure magazine newsletter sales aid
textbook billboard poster packaging television
other
12
Publication title (s)
13
Main head copy
14
Publication date
15
Press run / Circulation
16
Publication size
in inches
17
Ad size in inches
18
Image size
in inches
19
Image size
relative to page
 1/4 1/2 3/4 full page double page
20
Placement
 inside chapter opener cover inside/back cover
other
21
Distribution
 national regional local in-house
specify distribution area
22
 Electronic
and
additional rights
requested		 none
electronic
duration
other rights
23
Exclusivity
requested
non-exclusive exclusive other
24
Period of license
one-time 3 months 6 months 12 months
other
25
how many times
ad will repeat?
explain
26
Usage rights area
north american english language only international
other
27
 Language(s)
28
Can client provide
photo credit?
 yes no
29
Comments
or questions
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