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Sample Request for Permission to Digitize Images

Use College letterhead stationery.

Permission Department
Biological Productions
Mt. Vernon, CA 98876
Dear Sir or Madam:
As a faculty member of Central Virginia Community College, a nonprofit higher education institution of the Commonwealth of Virginia, I would like permission to use five slides from one of your collections. I plan to digitize the slides and use them in combination with other images in a PowerPoint presentation to show the development of a tree to General Biology students.
William M. Harlow. Slide Collection # 2392
Materials to be duplicated:
Slides 45 through 49
Type of Reproduction:
Digital copies will be made.
Number of Copies:
Only one copy will be made of each frame.
Use to be Made of Copies:
The five images will be shown in sequence within a PowerPoint presentation.
Distribution of Copies:
The PowerPoint presentation will be shown to three classes of General Biology students. Average class size is 25.
Enclosed for your convenience is a self-addressed stamped envelope. Please let me know what conditions, if any, apply to this use.

Joe Smith
Professor, Biology
Permission granted: _____________________________________ _______________
Signature                                                    Date
Conditions, if any:
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