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PERMISSION TO USE A COPYRIGHTED WORK
___________________________, hereby grants the University of North Carolina at Charlotte (“University”), the right to use, copy, distribute, publicly perform, make derivative works from, digitally transmit sound recordings, and publicly display a work, including digital reproduction and digital display on the internet or otherwise, or portion of work entitled ___________________________(“Work”) under the terms set forth below. The Work is a __________________[describe type of work]. __________________ holds the copyright in the Work. ___________________________ represents that the Work does not infringe the copyright or other legal rights of any third parties. The Work was copyrighted in the year __ .
All the following terms apply to this Permission:
The University may copy/reprint, including digital reproduction and digital display on the internet or otherwise the Work, and distribute and display it for use in _____________________ .
The copies will be used solely for nonprofit educational purposes in accordance with the mission of the University.
The copied material will not be sold.
This permission is non-exclusive, royalty-free (no cost to the University), world-wide, and perpetual.
All copies and displays of the Work by the University must credit _______________ as the creator of the Work, and must include full copyright information. Please indicate the form of attribution preferred.
If there are any other entities with a copyright interest in this work, please provide complete contact information.
Agreed to By:
Copyright Owner signature: _______________________________ Date: ___
Printed Name: ________________________________