Copyright Clearance Request Form

Reserves Request Form

Instructor's Full Name:
Department:
Phone:
E-mail:
Course Name:
Course Number: (4-digit dept code + 3-digit course code + 3-digit section code)
Campus Zip+4:
Semester/Year:
Number of Students:

This request is made with the purpose of teaching, scholarship or research in accord with the "Fair Use" provisions of the Copyright Law. I certify that I have read Section 107 of the Copyright Law and that this request, in my opinion, constitutes fair use of a copyrighted work, as permitted by law.

Copyright Clearance

Have you placed this item on Reserve previously?	Yes No
Is this photocopy less than 10% of the original source?	Yes No

Article or Chapter Title:
Journal or book title:
Author:
Volume/Number:
Pages:
Year of Publication:
Publisher:

The undersigned hereby requests that University libraries places this photocopied material on course reserve in I understand that EACH photocopy of an article or chapter MUST be submitted with a SEPARATE Copyright Clearance Request Form. Signature: Date:

PRINT and take this form WITH your single-sided, staple-free photocopy, to your Reserve Room Manager.
If you have any questions, please contact your Reserve Room Manager:
Bierce Library Reserve, Campus Zip+4: 1706, (330) 972-8246 Science Library Reserve, Campus Zip+4: 3907, (330) 972-7196

SECTION 107: LIMITATIONS ON EXCLUSIVE RIGHTS: FAIR USE - Public Law 94-55 Notwithstanding the provisions of section 106, the fair use of a copyrighted work, including such use by reproduction in copies or phonorecords or by any other means specified by that section, for purposes such as criticism, comment, news reporting, teaching (including multiple copies for classroom use), scholarship, or research, is not an infringement of copyright. In determining whether the use made of a work in any particular case is a fair use the factors to be considered shall include: the PURPOSE and CHARACTER of the use, including whether such use is of a commercial nature or is for nonprofit educational purposes; the NATURE of the copyrighted work; the AMOUNT and substantiality of the portion used in relation to the copyrighted work as a whole; and the EFFECT of the use upon the potential market for or value of the copyrighted work.