Podcast Permission Request

Name

This field is for validation purposes and should be left unchanged.

Requestor Information

Name*

First Last

Organization*

Your Title

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

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Is Your Billing Information the Same?

Yes
No

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Billing Information

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Billing Name

First Last

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Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Materials Requested

Please provide the following information about the podcast(s) you are requesting permission to distribute:

Podcast #1 Title*

Podcast #1 Speaker*

Podcast #1 Date*

Date podcast appeared on www.ccef.org

Podcast #1 Number of Listeners*

Do You Need to Request Another Podcast?*

No
Yes

Podcast #2 Title*

Podcast #2 Speaker*

Podcast #2 Date*

Date podcast appeared on www.ccef.org

Podcast #2 Number of Listeners*

Do You Need to Request a Third Podcast?*

No
Yes

Podcast #3 Title*

Podcast #3 Speaker*

Podcast #3 Date*

Date podcast appeared on www.ccef.org

Podcast #3 Number of Listeners*

Audience Information

Please provide the following information about your audience within the appropriate category.

Audience Type*

Choose your specific type*

Please specify your audience type*

Total Number of Recipients*

Audio Use Dates*

List when you’ll start to use resource and when you’ll stop

Choose your specific type*

Graduate Research
Ministry Research

Total Number of Recipients*

Audio Use Dates*

List when you’ll start to use resource and when you’ll stop

Choose your specific type*

Graduate
Undergraduate
Certificate
Other

Please Specify Other*

Course Title*

Include the title of the course in which the podcast(s) will be distributed.

Total Number of Recipients*

Podcast Use Dates*

List when you’ll start to use resource and when you’ll stop

Conditions of Use

1.) Completing and returning this form does not grant permission for you to use the podcast(s). We will notify you in writing whether permission is granted and of any additional terms and conditions of use.

2.) If CCEF grants permission, you may use copies of podcast(s) pursuant to the permission only for the purposes specified herein and in accordance with any other limitations, terms or conditions that CCEF communicates to you. Any impermissible or unauthorized use is a violation of the permission and license to use the podcast(s), and will result, exclusive of any other remedies available to CCEF, in immediate termination of your right to use podcast(s) for any purpose.

3.) MP3 podcast(s) cannot be downloaded or reproduced without prior authorization.

4.) MP3 podcast(s) shall not be condensed or adapted in any way.

5.) This permission does not grant you the right to license or distribute the MP3 podcast(s) to any other party.

6.) All rights not granted herein are retained by CCEF. Permission to use does not grant any rights of ownership in the podcast(s)

7.) If permission is granted, your usage of the MP3 podcast(s) signifies your acceptance of all terms and conditions herein and any other terms, conditions, or limitations of use communicated to you by CCEF.

Credit Line

You must include the following credit line with each distributed copy of the audio (when posting on a password-protected website, simply post this credit line on the page):

This recording is copyrighted by the Christian Counseling & Educational Foundation (CCEF). This recording is protected by U.S. and international copyright laws and may not be reproduced, transmitted, displayed, prepared as a derivative work, or performed in any form without the prior written consent of CCEF. The distribution of this audio is done with full permission from CCEF. All rights reserved. For more information on classes, materials, speaking events, distance education and other services, please visit www.ccef.org.

Message (Include any other relevant information regarding your request)

Electronic Signature

By completing this form electronically, your typed name acts as an authenticated signature for the application and an acknowledgment that you have read and understand the Conditions of Use of the application.

Full Name*

Organization (if applicable)