7 wheelchair racers in the middle of a race

Disability Resources & Educational Services

Sample Copyright Request DVD/VHS

The following is sample text that can be used for a copyright request for a DVD/VHS:



Dear {NAME}:

I am contacting you on behalf of the University of Illinois at Urbana-Champaign.

I am requesting permission on behalf of the University to use the following work:


This request is for permission to copy and caption the above DVD/VHS which is owned by Professor (name, course x) for accessibility purposes (e.g.- add closed captions/audio descriptions), as required by federal and state law in order to accommodate students with disabilities. The original DVD/VHS will not be returned to the instructor, but will be kept by the Accessible Media Office, so that only the DVD with captioning will be in circulation.

Our information indicates that (you/your company, __________), are/is currently the holder of the copyright. However, if you do not currently hold the rights, please provide me with any information that can help me contact the proper rights-holder. Otherwise, your permission confirms that you hold the right to grant this permission.

I hope that you will support our educational programs by granting this permission. If you require any additional information, do not hesitate to contact me at the address and number below.



Permission is hereby granted:

  • Signature: ___________________________
  • Name & Title: _______________________
  • Company/Affiliation: ______________________________
  • Date: __________________