Changing Hearts/Changing Lives Curriculum

Phone

This field is for validation purposes and should be left unchanged.

Before You Begin

This form is intended for those wishing to duplicate/distribute content from the Changing Hearts/Changing Lives curriculum.

Original versions of the video(s) and workbook(s) are not included as part of the permissions process and individuals must have access to them before submitting a permissions request.

If you are requesting permission for any other CCEF curriculum, please use the Curriculum Permissions form.

Requestor Information

Name*

First Last

Organization*

Your Title

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

This field is hidden when viewing the form

Is Your Billing Information the Same?

Yes
No

This field is hidden when viewing the form

Billing Information

This field is hidden when viewing the form

Billing Name

First Last

This field is hidden when viewing the form

Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Materials Requested

Please provide the following information about the material(s) you are requesting permission to distribute.

Duplication of video(s) and/or workbook(s) is the responsibility of the applicant. CCEF does not provide copies of the video(s) or workbook(s).

Number of DVD/Video duplications*

Enter “0” if not applicable

Number of workbook copies*

Enter “0” if not applicable

Audience Information

Please provide the following information about your audience within the appropriate category.

Audience Type*

Choose your specific type*

Please specify your audience type*

Total Number of Recipients*

Material(s) Use Dates*

List when you’ll start to use the material(s) and when you’ll stop

Choose your specific type*

Graduate Research
Ministry Research

Total Number of Recipients*

Material(s) Use Dates*

List when you’ll start to use material(s) and when you’ll stop

Choose your specific type*

Graduate
Undergraduate
Certificate
Other

Please specify other*

Course Title*

Include the title of the course in which the material(s) will be used.

Total Number of Recipients*

Material(s) Use Dates*

List when you’ll start to use material(s) and when you’ll stop

Distribution Format

Please provide the following information about how you intend to distribute the material(s).

Please note that digital video file(s) can only be distributed electronically.

Format

Digital
DVD (physical copy)

If approved, digital video file distribution is strictly limited to posting on a secure, password-protected intranet site and will be available only to the intended audience for the period of time that the usage has been approved. General public posting is prohibited.

Please specify digital distribution format*

Please refer to Conditions of Use (#3) below regarding distribution requirements.

Format*

Conditions of Use

1.) Completing and returning this form does not grant permission for you to use the materials(s). We will notify you in writing whether permission is granted and of any additional terms and conditions of use.

2.) If CCEF grants permission, you are authorized to make material(s) available only to the participants specified in the notice of permission, which may be more or less than the number you requested.

3.) If CCEF grants permission, your use of curriculum video file(s) pursuant to that permission will be limited as follows:
a.) Physical copies of DVDs will be available to the agreed-upon audience size and should not be distributed beyond the approved audience size. Redistribution by audience is prohibited.
b.) (If applicable) Digital video file(s) will be available to an agreed-upon audience size, through a password-protected website or intranet site for up to two years. If requested, extensions can be negotiated. General public posting is prohibited.

c.) (If applicable) Digital video file(s) will be available in a “view only” format. You shall not permit the video file(s) to be downloaded or reproduced by the individual viewer.
4.) If CCEF grants permission, you may use material(s) pursuant to the permission only for the purposes specified herein and in accordance with any other limitations, terms or conditions that CCEF communicates to you. Any impermissible or unauthorized use is a violation of the permission and license to use the material(s), and will result, exclusive of any other remedies available to CCEF, in immediate termination of your right to use the material(s) for any purpose.

5.) Reprints and/or copies are to be in the English language only.

6.) CCEF does not permit additions, deletions, or changes of any kind to be made to the material(s).

7.) This permission does not grant you rights to license, publish, or distribute to a third party.

8.) All rights not granted herein are retained by CCEF. Permission to use does not grant any rights of ownership.

9.) If permission is granted, your use of material(s) signifies your acceptance of all terms and conditions herein and any other terms, conditions, or limitations of use communicated to you by CCEF.

Credit Line

You must include the following credit line with each distributed copy of the Changing Hearts/Changing Lives workbook(s) or physical DVD(s):

Changing Hearts/Changing Lives is a publication of the Christian Counseling & Educational Foundation (CCEF). All content is protected by copyright and may not be reproduced in any manner without written permission from CCEF. For more information on classes, materials, speaking events, distance education and other services, please visit www.ccef.org.

Message (Include any other relevant information regarding your request)

Electronic Signature

By completing this form electronically, your typed name acts as an authenticated signature for the application and an acknowledgment that you have read and understand the Conditions of Use of the application.

Full Name*

Organization (if applicable)