REQUEST TO REPRINT COPYRIGHTED MATERIAL BY NONPROFIT ORGANIZATION

To: ______________________________________________ (Copyright Holder)
__________________________________________________ (Address)

Re: ____________________________________________ (Material to be Reprinted)

We, ____________________________ (Name of Organization), are preparing materials for the purpose of teaching _________________________ (Subject of Teaching). The previously mentioned materials will be used for/in ____________________________, and will be produced in _______ (Number) volumes. In all, we would like to distribute approximately __________ copies. The final product will be distributed without profit. Following the above stated guidelines, we request your permission to reprint the following material: ___________________________________________________.

In addition, we will include a credit line in the reproduction which states the following: This material was reprinted from ____________________________ (Name of Original Publication), with permission

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