Permission Letter for Electronic Reserve - Model

The following letter is a model, not a form letter. You must carefully examine your specific needs and modify the letter accordingly. It is also important to document your steps in the permission process. Keep good files!

[Date]

[Letterhead or Return address]

[Rights holder name and address]

Dear [Sir or Madam] [Permissions Editor] [Personal name, if known]:

In conjunction with a course I am teaching [where you work], I would like to place the following material(s) on the library's electronic reserve system:

[Citation with source information]

This request is for the [fall, spring, etc.] semester/term, [year], and for the following course:

[Department]
[Course number and title]
[Section number, if applicable]
[Number of students in the class]

At the end of the above-mentioned semester/term, the course reserve will be removed from the system and any further use will be renegotiated.

[Description of your electronic course reserve system. Is it password or IP address protected? Can it be accessed on and/or off-campus? Can students download and/or print the reserves?]

If you do not control the copyright on all of the above mentioned material, I would appreciate any contact information you can give me regarding the proper rights holder(s), including current address(es). Otherwise, your permission confirms that you hold the right to grant the permission requested here.

I would greatly appreciate your consent to my request. If you require any additional information, please do not hesitate to contact me. I can be reached at:

[Your contact information]

A duplicate copy of this request has been provided for your records. If you agree with the terms as described above, please sign the release form below and send one copy with the self-addressed return envelope I have provided.

Sincerely,

[Signature]

[Typed name]

Permission granted for the use of the material as described above:

Agreed to: ______________________________________________

Name & Title: ____________________________________________

Company/Affiliation: ______________________________________

Date: __________________________________________________