VARK®: PUBLISHER’S REQUEST – PRINT BOOKS

This form is for requesting to use our VARK® copyright materials in a forthcoming publication. The formats of those requests vary so we prefer to use our standard format for such requests. When this form is signed and returned we will process your request promptly and return it with an invoice and you can decide whether to proceed or not. Any payment is to be made in advance of permission. Final permission will follow by email after payment that can be made online. Our website at also has copyright information for publishers.

Copyright Requirements:

1Permission will be given for this edition only and is limited to non-exclusive, North American English, languageand distribution rights. Please advise any variations requested.

© Copyright Version 7.1 (2011) held by Neil D. Fleming, Christchurch, New Zealand.

2A complimentary copy of the book or a digital copy of our inserts is to be supplied within one month of publication.

3No charge is to be made by you for third parties requesting the right to copy our materials.

4The VARK questionnaire may not be placed on an interactive website.

VARK Permission Form for PRINT BOOKS

Publisher:
Title of book or publication:
Edition number:
Author(s):
Name of Editor: or Copyright Researcher
Email address:
Publisher’s address:
Number of Print copies to be printed:
Estimated retail price:
Publication date:
Has approval been given for a previous edition(s)?

The VARK copyright materials requested are:(Please check)

VARK Standard Questionnaire / VARK Helpsheets
VARK Younger Questionnaire / Other: please specify below
Other:
I have read and agreed to the copyright requirements above. (Please check)
Name:
Signature: / Insert your Electronic signature here.
Title/Position:
Our Name and Position
Neil D Fleming
VARK Learn Limited
50 Idris Road
Christchurch
New Zealand 8052. / Our Signature