Permission Slip form

To use the actors required in my music video I need permission to use them. Therefore we have had to construct a permission slip form to allow us to use the required actors. Here is what it looks like, I have used the name Bob as an example.

17/05/14

Flume

 Dear__Harley___,

My name is ___Aaron Black_____________ and I am currently studying A-Level Media Studies at Aldenham School. 

As part of my coursework this year, I am creating and producing a music video to a song of my choice.  I have chosen  ____Insane__   by  __Flume__ as the song I would like to create a music video for, and I am writing this letter to seek your permission to do so.

Please note, this video will be used only for my coursework and will not be distributed or marketed in any form.  I would greatly appreciate your permission to use this song.

Many Thanks,

Aaron Black