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Clearance Form Process

If you have reviewed copyright laws and resources but remain uncertain about whether you are within your legal rights to use a protected work, then you should document your efforts to lawfully use the work. The form below will be kept on file for six (6) years in the library to show your efforts to comply with copyright law.

Copyright Clearance Steps

  1. Review all copyright laws, guidelines and resources.
     

  2. Discuss copyright issues with Library Director/Copyright Officer.
     

  3. Complete the Copyright Clearance Form below.
     

  4. Print a copy of your form results for your own files.

Copyright Clearance Form

I.  Employee Information

 

Employee Name

 

Course Number

 

Course Format

 
 II.  About the Copyrighted Work

 

Title

 

 Author/Creator(s)
 For unwritten works, please enter artist, composer, producer, etc.
 
 


  

  

     

    

 

Date of Publication

         

 

Publisher

       

 

Place of Publication

       

 

 Format
Examples include book,
article, film, sound clip, etc.

    

 

How did you
 acquire the work?

    

 

When do you plan to begin use of the work?
Please provide month, day and year.

    

 

When do you plan to end use of the work?
Please provide month, day and year.

 
 III.  Fair Use Questions

Before using any copyrighted work in any classroom environment, you must consider how the use will stand up to the Fair Use Doctrine's Four Factor test. To learn more about this, visit the Fair Use part of this site.

 

Purpose of the Work
Describe how you intend to use the work and how it would enrich your class:

    

 

Nature of the Work
Choose the description that most accurately portrays the work in question.

Creative or fictional work that the creator developed from his own thoughts and experiences
 

Informational, researched work that the creator developed by drawing on the works of others

    

 

Portion of the Work
Describe how much of the work you would like to use in proportion to the entire work.

Examples:

  • 2 pages from a 250-page book

  • 45 secs. from a 60-minute film

  • 6 lines from a 20-line poem

  • Entire work

    

 

Impact of Using Work
Describe any financial impact on the copyright owner that would occur if many people used this resource in the manner that you intend.

 
 IV.  TEACH Act Questions*

* Required for online or Web-enhanced instructors only
Before using any copyrighted work in a distance learning classroom environment, the instructor, the college's technology staff and the institution must meet several requirements. Please complete the questions regarding instructional requirements and read about other measures taken by the college for the sake of compliance. To learn more, visit the TEACH Act part of this site.

 

Instructional Requirements

The copyrighted work that will be transmitted is:

a performance of a non-dramatic literary work
 

a performance of a non-dramatic musical work
 

a performance of any other work, including dramatic works and audiovisual works, but only in "reasonable and limited portions"
 

a display in an amount comparable to that which is typically displayed in the course of a live classroom session

The copyrighted work has not been created and marketed primarily for use in a digitally transmitted instructional activity.

True
 

False

The copyrighted work is not a textbook, course pack, or other materials which is typically purchased or acquired by students for their independent use and retention.

True
 

False

The use of the copyrighted performance or display is:  (check all that apply)

made by, at the direction of, or under the actual supervision of an instructor as an integral part of a class session offered as a regular part of the systematic, mediated instructional activities of the college.
 

directly related and of material assistance to the teaching content of the transmission.
 

an integral part of a class session offered as a regular part of the systematic, mediated instructional activities of the college.

Neither the instructor nor the college suspect that the copyrighted work in question was unlawfully acquired.

True
 

False

If the copyrighted work has been converted into a digital format from another media type such as print or analog, then the quantity of the work converted is no greater than the amount that can be lawfully used for the course.

True
 

False

No digital version of the copyrighted work is available to the college.

True
 

False

The only digital versions of the copyrighted work available to the college are technologically protected to prevent its lawful use in the course.

True
 

False

 

Technological Requirements

Piedmont Technical College and its Division of Instruction Support Technology have taken the following technological measures to comply with the TEACH Act:

  • The IST Division has taken technological actions to restrict student access to copyrighted materials for longer than the defined class session.
     

  • The IST Division has taken technological actions to deter unauthorized dissemination of copyrighted materials by students to others.
     

  • Piedmont Technical College does not interfere with technological measures taken by copyright owners to prevent retention or unauthorized sharing of their works.
     

  • The IST Division houses copyrighted works on a computer system or network in such a way that it is not ordinarily accessible to unauthorized users.
     

  • The IST Division will only maintain the copy of the copyrighted work for a period of time that is reasonably necessary to facilitate the transmissions for which it was made.
     

  • Copies made for the sake of transmission are retained and used solely by Piedmont Technical College.

Institutional Requirements

Piedmont Technical College has taken the following institutional measures to comply with the TEACH Act:

  • Piedmont Technical College is an accredited, non-profit educational institution.
     

  • Piedmont Technical College has instituted policies regarding copyright.
     

  • Piedmont Technical College has provided materials to faculty, students, and relevant staff members that describe and promote United States Copyright Laws.
     

  • Piedmont Technical College has provided notice to students that materials used in connection with courses may be subject to copyright protection.
     

  • Transmission of course content is made solely for students officially enrolled in the course for which the transmission is made.

 

Sources
Some of the information used on this page came from these sources:

Disclaimer
 Please note that the information presented in the Online Copyright Center is for information purposes only. It should not be used as a substitute for actual legal advice.

 

 Last Updated July 13, 2006