| [letterhead stationery or return address]
[Date] [Name and address of addressee] Dear ______________________: I am completing a doctoral dissertation at The University of Memphis entitled "_______________________." I would like your permission to reprint in my dissertation excerpts from the following: [Insert full citation and description of the original work.] The requested permission covers future revisions and editions of my dissertation and to the prospective publication of my dissertation by UMI. These rights will in no way limit republication of the material(s) in any other form by you or others authorized by you. Your signing will verify that you own [or your company owns] the copyright to the above material(s). If this meets with your approval, please sign this letter below and return it to me in the enclosed return envelope. Thank you very much for your attention to this matter. Sincerely, [Your name and signature] Enclosure PERMISSION GRANTED FOR THE USE REQUESTED ABOVE: __________________________
Date: _________________________ |
| PERMISSION GRANTED FOR THE USE REQUESTED ABOVE:
[Type name of company] By: ________________________________ Title: ______________________________ Date: _________________________ |