Copyright Clearance Request (CCR) Form

Contact Information
instructor's first name	*
instructor's last name	*
phone number	*
email address	*
course name	*
course number	*
number of students	*
start of term date	*	Enter as 'mm/dd/yyyy'
banner dept. billing code	*	If you don't know this code, contact your Department Administrator
Request Information
reserve type	*	Print Electronic
request type	*	Book Chapter Journal Article

WARNING CONCERNING COPYRIGHT COMPLIANCE

The copyright law of the United States (Title 17, United States Code) governs the making of photocopies or other reproductions of copyrighted materials. Under certain circumstances specified in the law, libraries and archives are authorized to furnish a photocopy or other reproduction. One of these specified conditions is that the photocopy or reproduction is not to be "used for any purpose other than private study, scholarship or research." If a user makes a request for, or later uses, a photocopy or reproduction for purposes in excess of "fair use," that user may be liable for copyright infringement. This institution reserves the right to refuse to accept a copying order, if in its judgment, fulfillment of the order would involve violation of the Copyright law.

Reserves Department | (202) 994-1827 or (202) 994-3685 | mlbrsv@gwumc.edu