Application to Quote, Publish, Or Distribute Audio And/Or Transcripts
Special Collections, Carrier Library, James Madison University / 1
Instructions
1. If you are seeking permission to use audio/visual material, including transcripts, please use Application to Quote, Publish, or Distribute Audio/Visual Material.
2. Complete the form, sign, and return to Special Collections, Carrier Library, MSC 1704, 880 Madison Drive, James Madison University, Harrisonburg, VA 22807.
3. This application is not approved until the approval signature and date is complete.
4. If approved, a copy of the signed form will be returned to you.
5. If denied, you will be notified.
NAME (please print): ______
PERMANENT ADDRESS: ______
______
PHONE: ______
EMAIL: ______
INFORMATION ABOUT THE PROPOSED PUBLICATION IN WHICH QUOTE(S) IS(ARE) TO APPEAR:
TITLE OF BOOK or ARTICLE
____________
______
PUBLISHER or PERIODICAL NAME
______
______
ANTICIPATED PUBLICATION OR DATE[S]
______
MATERIAL FOR WHICH PERMISSION TO USE IS SOUGHT (give specific collection titles and numbers and identify specific items, where applicable; attach separate sheet if necessary.)
______
______
______
AGREEMENT: By signing this application, the applicant agrees to the following conditions: 1) to use the material cited above ONLY in the specific publication named above; 2) to give credit in footnotes and bibliographies, and to give it as per the following example: John Doe Collection, [Collection Number], Special Collections, Carrier Library, James Madison University, Harrisonburg, VA, 22807; 3) to expressly assume all responsibility for observing applicable laws of copyright and libel and to exonerate, indemnify and hold the University and its agents harmless for all loss, cost, damage or expense arising in any way connected with the use of the material identified above; 4) to provide Carrier Library two (2) copies of the published work/venue in lieu of publication permission fees.
Signature of Applicant ______DATE______
Signature of SC Librarian _______DATE______
Special Collections, Carrier Library, MSC 1704,880 Madison Drive, James Madison University, Harrisonburg, VA 22807
Phone: 540-568-3612 Email: