Permissions and Licensing Online Intake Form
All content on organizational websites and Academy properties is copyrighted by the Academy of Nutrition and Dietetics. No content may be reprinted, copied or electronically reproduced or used — except where specifically noted — without prior expressed permission by the Academy. Please allow 5-10 BUSINESS days for a response from our team on your submitted application. Incomplete applications will not be considered. To request permission to reprint, adapt or license content from an Academy product or resource, please complete the form below.
Applicant and Request Details
Date Submitted
-
Month
-
Day
Year
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Submitted By
Department / Internal Sponsor
Opportunity / Request Name
Organization Name
Primary Contact Name
Contact Email
example@example.com
Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Organization Website
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization Profile
Organization Type
Healthcare Organization
Academic Institution
Professional Association
Corporation / Commercial Entity
Government Agency
Nonprofit Organization
Media Organization
Other
Brief Description of Organization and Activities
Requested Content and Materials
Title and Description of Requested Content or Assets (Provide SPECIFIC details: title, ISBN, table/figure/page number, URL, etc.)
Are supporting materials also expected to be included?
Graphics / Images
Charts / Tables
Datasets
Templates / Tools
Updates / Revisions
Other
If other:
Intended Use and Audience
Describe how the requested content will be used
Select all that apply:
Internal Organizational Use
Educational Use
Customer-Facing Use
Commercial Product or Service
Platform / Technology Integration
AI-Related Use
Derivative Content Development
Research / Analysis Use
Translation / Localization
Other
If other:
Please upload any mockups, supporting documentation, etc. in relation to the propose product or service.
Browse Files
Drag and drop files here
Choose a file
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Scope of Use
Who will access or benefit from the content?
Estimated User Population / Audience
Will third parties have access to the content?
Please Select
Yes
No
Unknown
Is exclusivity being requested?
Please Select
Yes
No
Unknown
Revenue Model
What is the revenue model for this program or product (e.g., pharma sponsorship, direct sales, other)?
Pricing
Distribution & Translation
In which countries do you wish the content to be distributed?
Do you intend / wish to translate the content?
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