Copyright Clearance Services

Copyright Permission Request

Non-Print Materials

Note: All fields marked with a * are required to submit your request.

Requester's Information

* Name:
* Email Address:
* Phone:
* Program/Department:

Copyright Information

* Title of Video/CD/DVD or
  Other Nonprint Material:
* Producer:
* Clips/Segments to be Used:
* How will Material be Used?
* For What Period of Time?
  (Please include start/end dates)
* Copyright Holders Address: