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Sample Permission Letter for Classroom Use

[UNIVERSITY LETTERHEAD]

[date]

[Name and address of copyright owner indicated in copyright notice]
Dear __________________:
I am a professor of ______________________________ at North Carolina State University. I would like to reproduce and distribute the following material to students and auditors in University courses:
Title of Work: __________________________________

Edition or Date: _________________________________

Author: _______________________________________

Portion(s) of work to be used: _____________________ [Describe specifically by pages, sections, chapters, etc. ..]
This material will be used for [describe purpose]. I anticipate that classes will use this material ______ times per academic year and that each class will have approximately _____ students. I intend to have this material copied using [describe copying process, e.g. photocopiers, offset, etc.]
Copies of this material will be made and distributed only (1) to students and auditors in University-related classes, (2) on a nonprofit basis, (3) when, for pedagogical or other reasons, it is not practical to assign the entire work from which this material is taken. We will include your copyright notice in our copies of this material.
While I believe that copying and distribution of this material as descried above is "fair use," in the interest of greater certainty I would appreciate your consent. [Delete this sentence if untrue.]
Please indicate your consent by signing the enclosed copy of this letter and returning ito me in the enclosed envelope.

Also, please use the appropriate spaces at the end of this letter to indicate the name and address of any other person whose consent might be required.
Very truly yours,

[name of professor]
[title]

Enclosure
Consent granted to:
[Legal name of copyright holder]

By: _______________________________________________ [Signature]

Name: _____________________________________________ [Please Print]

Title: ______________________________________________

Date: __________________

Other persons to contact for consent:

Name(s): __________________________________________________

Address(es): _______________________________________________

Telephone No(s): ___________________________________________

 

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