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[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 excerpts to be reproduced are: [insert detailed explanation or attach copy].
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 materials 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 materials.
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:
__________________________ [Type name of addressee below signature line]
Date: _________________________
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