Date:

Permissions Department

[Fill in appropriate address]

Dear Reader:

This letter is a request for permission to use for the Problem-Centered Teaching and Learning Website at Auburn University (http://www.auburn.edu/pctl), the following:

Title:

Copyright:

Author(s):

Material to be duplicated: [Be specific as possible with page numbers, issue/volume numbers, etc.]

Manner of distribution: One digital copy of this material [ will be available on the http://www.auburn.edu/pctl website. OR will be available on the http://www.auburn.edu/pctl website on a protected server to students enrolled in the Auburn University Curriculum & Teaching class _______]

Purpose of use/reproduction: Non-profit, educational use. The Auburn University Problem-Centered Teaching & Learning site is part of the U.S. Dept. of Education's Preparing Tomorrow's Teachers to Use Technology initiative. The material will be used in the Auburn University teacher education program to provide models of how powerful curriculum materials may be used to promote problem-centered learning.

A self-addressed, stamped envelope is enclosed for your convenience. [include this only if sending by mail]

Sincerely,

Name [requesting faculty member]

Department of Curriculum & Teaching

Auburn University

5040 Haley Center

Auburn, AL 36849

Permission granted:

Date:

Conditions, if any:

Auburn University PCTL Project Request for Permission

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