<p> CARIBBEAN EXAMINATIONS COUNCIL</p><p>COPYRIGHT USAGE REQUEST FORM</p><p>APPLICANT’S NAME: DATE: (State company name, if applicable) (dd/mm/yyyy)</p><p>APPLICANT’S ADDRESS: (State company address, if applicable)</p><p>TELEPHONE NUMBER: FAX NUMBER: E-MAIL ADDRESS:</p><p>ITEM(S) REQUESTED AND SOURCE: (Specify which items and where they were found. Include name of examinations, page numbers, dates, etc)</p><p>INTENDED USE: (1Commercial aspects of your product – publication, CD, website, etc – and the method and form of marketing)</p><p>DETAILS: (Additional significant information) </p><p>I, ______, the undersigned, agree on behalf of the abovementioned entity to abide by the Terms and Conditions for the Granting of Permission for use of CXC® Copyright Materials.</p><p>NAME: (Please print)</p><p>TITLE:</p><p>SIGNATURE:</p><p>Please complete and return by mail, e-mail, or fax to:</p><p>The Senior Assistant Registrar Examinations Development and Production Caribbean Examinations Council The Garrison, St Michael BB14038, BARBADOS Tel: +1 (246) 227-1700: Fax: +1 (246) 429-5421; Email: [email protected]</p><p>Note: The approximate time for receiving a response to a request is six to eight weeks.</p>