Appendix HSample Materials Release Form
(Consult with an attorney before using)
(INSERT YOUR COMPANY NAME), respectfully requests permission to use
____________________________________ which will become part of the video program entitled, ____________________ produced by (YOUR COMPANY NAME).
The rights I am seeking are world rights in all languages for reproduction in all forms and media, including electronic media, in this and any future revisions and editions of the work published by (YOUR COMPANY NAME).
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