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Online form for internal parties asking the Copyright Office to seek permission to use external material
Requestor's Name
Requestor's organisation/department
Email
Telephone
Address
Full citation of the material you want to use
Location of the material you want to use; if online, please insert url
What date do you need to receive the permission by?
Organisation that owns copyright in the material
Email
Telephone
Address
How much do you want to use?
Full item
Certain section
If a certain section, please specify
What format is the material? (Check all that apply.)
Online
Print
Multimedia (i.e. CD-ROM, DVD)
Other - please specify:
What kind of work is the material; journal article; song; photograph etc?
Will this material be uploaded by Digital Media Services?
Yes
No
How many copies do you want to make of the material?
Please give a detailed description of where you would like to reproduce the material, i.e. on a learning management system; in a book; on a web site etc.
Please give a detailed description of what the material will be used for, i.e. in a course of study; for internal staff use; as an academic commercial publication etc.
Please indicate how long you will intend to use the material for, i.e. for one semester, indefinitely etc.
Please indicate if you wish to adapt, modify or change in any way the material you are requesting permission for.
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