Permission Request Form

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  • 8/9/2019 Permission Request Form

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    NOT VAL ID UNTIL SIGNED BY ELECTRONIC ARTS, THEN COUNTER-SIGNED BY REQUESTOR Page 1 of 3

    ELECTRONIC ARTS INC.PERMISSION REQUEST FORM

    Thank you for contacting Electronic Arts Inc. ( EA) regarding your use of EA Materials as noted below for the purposedetailed herein. Permission is not granted until form is signed by EA, countersigned by you and returned to EA.

    STEP 1: Complete Sections I through III in their entirety and submit the form, along with the EA Materials you wish touse, via email [email protected] not sign form at time of your original request.

    STEP 2: EA will review the completed form. Please note that your request may take a few weeks.

    STEP 3: If EA grants you permission, EA will add the legal notices and any other conditions that must accompany youruse and return it to you for signature. You must consent to the terms and conditions, sign the Permission Request Formand return via email. IF EA does not grant permission, you will be notified via email.

    I. REQUESTORName:Company:Address:Phone:Email:

    II. EA MATERIALProduct name (Game Title):

    SoftwareGame FootageScreen ShotWeb ImageCover Image (package)

    Other (describe):

    III. REQUESTED PURPOSE(Complete A, B, C, D or E)

    A. PUBLICATION** Submit image and relevant portion of text or context of publication. Permission Requests Team does not provide images

    Criticism/CommentScholarship/ResearchTeaching

    Other (please explain):

    Publication Title:Topic:Target Audience:Author(s):Publisher:Publication date:Print or Web Based:

    B. PRESENTATIONNature of presentation:Target Audience:Date(s) of Presentation:Presentation Location:

    mailto:[email protected]:[email protected]:[email protected]:[email protected]

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    NOT VAL ID UNTIL SIGNED BY ELECTRONIC ARTS, THEN COUNTER-SIGNED BY REQUESTOR Page 2 of 3

    C. FILM OR TELEVISION** Submit relevant portion of script or summary of context. Permission to include music may not be provided.

    AdvertisingDocumentaryEditorialFictional

    Explain use in detail:

    D. WEBTo be displayed at URL:Explain use in detail:

    E. CLASSROOM INSTRUCTIONDemonstrationHandoutInstalled on Computers. List number of PCs:

    Grade level:Class title:

    F. TOURNAMENTSGame title:

    Fee based or Non-fee based

    Once you have completed Sections I through III in their entirety, return the completed form to EA.

    DO NOT SIGN FORM AT THIS POINT.

    IF EA grants yo u permiss ion to use EA Mater ia ls , you mus t consent to the terms and condi t ions entered in

    Section VI below, execute the Permiss ion and return the com pleted form via email .

    IV. LEGAL NOTICES (TO BE COMPLETED BY EA)The following legal notices are to be included on or within your use of the EA Materials as identified on this form:

    V. OTHER CONDITIONS AS DEFINED BY ELECTRONIC ARTS:

    Electronic Arts Inc.

    __________________________________ _______________________Signature Date

    VI. REQUESTORS CONSENT (only after EA has granted permission to use EA Materials)

    By signing below, the Requestor acknowledges and agrees to the following Terms and Conditions.

    This document creates no legal rights or responsibilities unless and until signed by EA and the Requestor accepts theterms and conditions herein. EA grants to the Requestor a non-exclusive, limited use license to use the EA Materialssolely as described in this license. Requestor may not use any other materials relating to any EA (or wholly-ownedsubsidiary) product, such as full motion video, music, voice-over, real-time photos, or any other graphic representations,unless such additional material is pre-approved in writing by EA.

    Requestor will include all legal notices set forth in Section IV and abide by any other conditions set forth in Section V.

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    NOT VAL ID UNTIL SIGNED BY ELECTRONIC ARTS, THEN COUNTER-SIGNED BY REQUESTOR Page 3 of 3

    Requestor shall acquire no rights in or to these EA Materials and may not use them in any way other than as specified inthis license. Any use, other than as specified herein, will require the prior written approval of EA. All goodwill associatedwith the EA Materials, whether gained through Requestors authorized use herein, or otherwise, remain the sole propertyof EA, its affiliates and licensors.

    ACCEPTED AND AGREED:

    __________________________________ _______________________Requestor Signature Date

    Once EA grants permission to use materials, Requestor must sign above and email back [email protected]

    http://c/Users/sgarfield/AppData/Local/Microsoft/Windows/Temporary%20Internet%20Files/Content.Outlook/Local%20Settings/Temporary%20Internet%20Files/Content.Outlook/Local%20Settings/Temporary%20Internet%20Files/Content.Outlook/FUD7N302/[email protected]://c/Users/sgarfield/AppData/Local/Microsoft/Windows/Temporary%20Internet%20Files/Content.Outlook/Local%20Settings/Temporary%20Internet%20Files/Content.Outlook/Local%20Settings/Temporary%20Internet%20Files/Content.Outlook/FUD7N302/[email protected]://c/Users/sgarfield/AppData/Local/Microsoft/Windows/Temporary%20Internet%20Files/Content.Outlook/Local%20Settings/Temporary%20Internet%20Files/Content.Outlook/Local%20Settings/Temporary%20Internet%20Files/Content.Outlook/FUD7N302/[email protected]

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