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(for photocopies and music reproductions)
A COMPLETED COPY OF THIS FORM MUST ACCOMPANY
EACH ARTICLE TITLE TO BE PLACED ON RESERVE. RESERVE MATERIALS
MUST COMPLY WITH COPYRIGHT REGULATIONS.
See Hutchins Library
Copyright Policy for further information.
Instructor _________________________________ Phone
ext. __________
Course _____________________________________ Section __________
Date placed on reserve ____________________ for _______________ term
Individual article or selection assigned from the work:
(According to copyright guidelines it is acceptable to place a photocopy of
an article on reserve for one term. Material must contain
notice of copyright from the source.)
Copied from:
Monograph Author
________________________________________________________
Monograph Title
________________________________________________________
OR
Periodical Title
________________________________________________________
Date _____________ Vol. _____ Issue _____ Pages _________
Type of reserve:
______ Not to leave the library
______ Overnight (can be checked out 1 hour prior to closing)
______ 3-day
PLEASE READ, SIGN, AND DATE THE FOLLOWING STATEMENT REGARDING
COPYRIGHT.
I understand that systematic reproduction of copyrighted material
is a violation of copyright law. My students will be assigned to study this
material, not to copy it.
My signature certifies that the above listed materials to be
placed on reserve comply with federal copyright laws for library
reserve use or permission has been granted or are not copyrighted.
Signature ___________________________________ Date ___________
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