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Podcasts - Creating

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If you agree to grant the requested permission, please complete and sign the attached form and return a copy to [Name and Unit] at the following fax number [Insert Fax Number] or return by mail in the self addressed return envelope provided.

If you are not the rights holder of the Work, we would appreciate it if you would provide us with any contact information you have about the rights holder.

If you require any additional information regarding this request please contact [Name and Unit] on [Insert Phone Number] or [Insert Email Address].

Yours Sincerely,

[Name and Title]

Permission to Use Copyright Work in a Podcast

Work

[Insert Name Or Description Of Work]

Name

[Insert Name]

Company / Organisation

[Insert Company Or Organisation Name]

Address

[Insert Address, If Known]

Telephone Number/s

[Insert Telephone Numbers, If Known]

Fax Number

[Insert Fax Numbers, If Known]

Email address

[Insert Email Address, If Known]

I confirm that I am the rights holder of the Work, and I authorize the use of the above Work in a podcast produced by students at [school] without payment for the full term of the Work’s copyright.

Please indicate the permission granted by ticking the appropriate box.

The school’s intranet for students and teachers to access at school, home and the school’s publicly accessible website

The school’s secure intranet for students and teachers to access at school and home

The school’s secure intranet for students and teachers to access at school only

Please credit me as follows:_________________________________________

Permission is not granted for the use of the material as described above.

I am not the rights holder of the Work. The contact details of the rights holder are as follows:

In the case of individuals: information contained on this form has been collected in order to administer educational programs for students in the [Department’s or Educational Body’s] schools. This may be personal information and will be stored, used and disclosed in accordance with the requirements of the Privacy Act 1988 (Cth).

Signature:

 _________________________________

Date:

 _________________________________

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