Permissions Request Form

Please use this form to request permission from Frederick Buechner Literary Assets, LLC ("FBLA") to use material created by Frederick Buechner in your project. It is important that you complete all fields. Once you have completed the form, please use the “Submit” button at the bottom of the page. Alternatively, you may download a printable form here and email it to permissions@frederickbuechner.com.

Please note that submitting a completed form does NOT mean that you have been granted permission to use Buechner material. Submitting a request is the first step in the process. Upon receipt of your request, FBLA will review it and should FBLA decide it wishes to grant you permission, you will be sent a Permission Agreement for your signature and return to us.

Name *
Name
Address *
Address
Phone *
Phone
If under 250 words, please provide an exact quote. Otherwise provide exact description.
For Intended Use
For Intended Use
For Intended Use
Planned Date of Publication
Planned Date of Publication

PLEASE NOTE: Frederick Buechner Center, Frederick Buechner Literary Assets, LLC, and Frederick Buechner make no representations or warranties concerning the extent of their rights in any copyrighted material and cannot speak for other potential rights holders and licensees, including publishers. It is your responsibility to obtain all necessary licenses and permissions from any third party with respect to copyrighted material you wish to use.