Sample Letter Requesting Permission to Use an Image for Classroom Use
Today’s Date: _________________________________________________________
Printed Name of Right’s
Holder: _________________________________________
Description and/or Title of
the Gift: _______________________________________
______________________________________________________________________
Pursuant to the provisions of THE COPYRIGHT ACT OF THE UNITED STATES OF AMERICA, TITLE 17 OF THE US
CODE, I, the undersigned, authorize Visual Resources Center, the Center for
Teaching and Learning, and Doherty Library the non-exclusive rights to
duplicate, distribute, create derivative works, publicly perform and publicly
display the images listed either below, on the back of this authorization, or
on an attached sheet through any analog and/or digital means, for any and all
educational uses at Centre College. Furthermore and unless otherwise specified
by the undersigned, the rights holder’s name and copyright date will be
associated with any and all public displays and performances, derivative works,
duplications and distributions. It is
understood that these images and the intellectual property contained therein
are owned solely by the undersigned.
By signing below, I agree that
Centre College may use any or all analog and/or digital duplicates created by
the Visual Resources Center for the following purposes:
• Traditional face-to-face teaching
• Synchronous and asynchronous teaching through but
not limited to the following:
o Storage on
and retrieval from a University server for educational purposes
o Asynchronous
and synchronous Internet courses
•
Research
• Scholarship and scholarly activities
• Criticism and commentary
• Multimedia projects
• Library catalogs
The Visual Resources Center,
CTL, and Doherty Library cannot authorize publication of these images.
Publication of these duplicates requires permission from the owner.
Signature of Rights Holder
__________________________________________________________
Signature of Visual
Resources Center Curator __________________________________________