Permission for sample items in published work

Note: This form is for publications such as books, articles, magazines, journals, and textbooks. (It is not for dissertations and theses - details here and here).

Mind Garden will only provide permission for up to five sample items. Even if permission is given for up to five sample items for reproduction, they should not represent a whole scale (e.g., the MLQ has four item scales). The goal is to provide an example of content, not to provide a usable scale.

To request permission to include sample items in a published work, please complete the following form (* Required) and arrange for payment of the $100 fee. An agreement form will be mailed to you with additional instructions.

Agreement Information

Instrument, Manual, Workbook,* Bibliography or Scoring Key: (scroll down for specific type)	Select one Abuse Risk Inventory for WomenAdjective ChecklistAuthentic Leadership QuestionnaireBarron Welsh Art ScaleBass Orientation InventoryBem Sex Role InventoryCalifornia Q-Sort for AdultsCalifornia Q-Sort for ChildrenChapin Social Insight TestClassroom Environment ScaleCommunity Oriented Programs Environment ScaleCoopersmith Self-Esteem Inventory Adult FormCoopersmith Self-Esteem Inventory School FormCoping Operations Preference EnquiryCoping Resources InventoryCorrectional Institutions Environment ScaleCorrectional Officers' Interest BlankDeveloping the Leader WithinDynamic Factors SurveyEnright Forgiveness InventoryFamily Environment ScaleFive Factor Wellness InventoryFlow: CORE Dispositional ScaleFlow: CORE State ScaleFlow: LONG Dispositional Scale - GeneralFlow: LONG Dispositional Scale - PhysicalFlow: LONG State Scale - GeneralFlow: LONG State Scale - PhysicalFlow: SHORT Dispositional ScaleFlow: SHORT State ScaleFriedman Well Being ScaleGroup Embedded Figures TestGroup Environment ScaleHassles and UpliftsHealth and Daily Living FormHoffman Vocational Values ScaleImpact Message Inventory -- CircumplexJourney of Self-DiscoveryMarital Attitude EvaluationMathematics Self-Efficacy ScaleMilitary Environment InventoryMultifactor Leadership QuestionnaireMultifactor Leadership Questionnaire for TeamsNeuropsychology Behavior and Affect ProfileOlder Persons Counseling Needs SurveyOrganizational Description QuestionnairePerceived Stress ScaleProfiles of Organizational Influence StrategiesPsychological Capital QuestionnairePsychological Ownership QuestionnairePsychotherapy Outcome KitSchool Situation SurveySocial Climate Scales: A User's GuideSocial Insight TestSocial Reticence ScaleSocial Skills InventoryState-Trait Anger Expression InventoryState-Trait Anxiety Inventory for AdultsState-Trait Anxiety Inventory for ChildrenState-Trait Anxiety Inventory in PortugueseState-Trait Personality InventoryTest Anxiety InventoryUnderstanding and Getting Free of Abuse WorkbookUniversity Residence Environment ScaleWard Atmosphere ScaleWays of Coping QuestionnaireWellness Evaluation of LifestyleWelsh Figure Preference TestWork Environment Scale Barron Welsh Art ScaleBass Orientation InventoryBem Sex Role InventoryCalifornia Q-Sort for AdultsCalifornia Q-Sort for ChildrenChapin Social Insight TestClassroom Environment ScaleCommunity Oriented Programs Environment ScaleCoopersmith Self-Esteem InventoryCoping Operations Preference EnquiryCoping Resources InventoryCorrectional Institutions Environment ScaleCorrectional Officers' Interest BlankDynamic Factors SurveyEnright Forgiveness InventoryFamily Environment ScaleFive Factor Wellness InventoryGroup Embedded Figures TestGroup Environment ScaleHassles and UpliftsHealth and Daily Living FormImpact Message Inventory -- CircumplexMarital Attitude EvaluationMathematics Self-Efficacy ScaleMilitary Environment InventoryMultifactor Leadership QuestionnaireMultifactor Leadership Questionnaire for TeamsNeuropsychology Behavior and Affect ProfileOlder Persons Counseling Needs SurveyOrganizational Description QuestionnaireProfiles of Organizational Influence StrategiesPsychotherapy Outcome KitSchool Situation SurveySocial Insight TestSocial Reticence ScaleSocial Skills InventoryState-Trait Anger Expression InventoryState-Trait Anxiety Inventory for AdultsState-Trait Anxiety Inventory for ChildrenState-Trait Anxiety Inventory in PortugueseState-Trait Personality InventoryTest Anxiety InventoryUniversity Residence Environment ScaleWard Atmosphere ScaleWays of Coping QuestionnaireWellness Evaluation of LifestyleWork Environment Scale A Journey of Self-DiscoveryAbuse Risk Inventory for WomenFive Factor Wellness InventoryOvercoming Depression and Loss WorkbookUnderstanding and Getting Free of Abuse WorkbookUnderstanding and Managing StressUnderstanding and Managing Your AnxietyWellness Evaluation of Lifestyle Classroom Environment Scale Annotated BibliographyCommunity Oriented Programs Environment Scale BibliographyFamily Environment Scale Annotated BibliographyWard Atmosphere Scale Annotated BibliographyWork Environment Scale Annotated Bibliography Welsh Figure Preference Test
Items to be reproduced:*	Select one 5 sample items Table (identify which page and table in comments) Figure (identify which page and figure in comments) Text (identify which page and text in comments) Other (please explain in comments)
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THE FOLLOWING APPLY TO YOUR PROPOSED PUBLICATION
Author(s) of your article:*
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Name of Book or Magazine, etc.:*
Expected Publication Date:*	Select One 20102011201220132014
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Expected Copyright date:*	Select One 20102011201220132014

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