Application to Quote, Publish, Or Distribute Audio And/Or Transcripts

Application to Quote or Publish from Collections 1 Special Collections, Carrier Library, James Madison University

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: [email protected]