Statement of permission to use material

(The text below should ideally be pasted into a document bearing the letterhead of the exam centre.)
To Whom It May Concern:
As part of my GCE Advanced Level work in English Language, I am conducting a Language Investigation. To do this, I am required to find real language data, and interpret them according to theoretical models of language.
As you have kindly supplied such data, I need your consent for the use I will make of them in this task. This letter explains what will happen to the data you have provided, and has a space for you to show your agreement to this. If you have any further questions about the Language Investigation, please contact the supervising teacher or head of department at my school.
If you have provided written data, I may make a typed copy, and may quote from the data. If you have provided spoken data, I will transcribe these.
The data you have supplied will be seen by the teacher supervising the investigation, and may be seen by other teachers running the GCE Advanced Level course, as well as by moderators (examiners) of coursework who assess the work of candidates at the school.
If my teachers or I wish to place the investigation in the public domain (by print, broadcast or Web publishing) they or I will seek your permission. If you give permission, the publication of your data will conform to normal ethical procedures for scientific research – your surname will be shown only as an initial, and other identifying information will not appear
Please show your consent to my use of the data you have supplied by signing the form below.

Thank you for your help,

-Signature-								-Signature-
Student Investigator 							Supervising Teacher
Statement of permission

I have read the information about the use that will be made of language data that I have supplied. I am the person legally entitled to give permission to use these data, which were originally written or spoken by me or by a child of whom I am the parent or legal guardian, and on whose behalf I can give such permission. 

I agree to allow you to use the data I have provided. You may use these data only in the way you have described. If you wish to publish the data, you will seek my further permission for this. 

Signed:				(Print name):					Date: