Permission Letter for Audiovisual Uses in
Distance Education - 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 distance education course I am teaching
at [where you work], I would like to use the following material on a
class web site to supplement my instruction of this class:
[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]
Any use in future semesters/terms will be renegotiated.
[Description of the web site. Include any special features
such as passwords and who hosts the web site. Include the format, such
as sound or movie files. (*.WAVs, *.PDFs, RealAudio, *.AVIs, etc.)]
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: __________________________________________________