Thesis Permission Form

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UNION COLLEGE HONORS THESIS COPYRIGHT AND PERMISSION FORM

Student Name*

First Name

Middle Name (optional)

Last Name

Permanent, Non-Union Email*

Union Email*

Your @union.edu email address

Graduation Date (month/year)*

How many additional authors are to this thesis, if any?

1 2 3

Additional Author Name One*

First Name

Last Name

Additional Author Email One*

Additional Author Name Two*

First Name

Last Name

Additional Author Email Two*

Additional Author Name Three*

First Name

Last Name

Additional Author Email Three*

Thesis Department One*

Thesis Department Two

Thesis Title*

Primary Thesis Advisor (Enter the name of the advisor who has agreed to sign this form.)*

First Name

Last Name

Primary Thesis Advisor Email*

Digital Archive Email

Secondary Thesis Advisor

First Name

Last Name

Secondary Thesis Advisor Email

UNION COLLEGE COPYRIGHT AGREEMENT

I certify that the version of my thesis that I submitted is the same as that approved by my advisor(s).

I also hereby grant to Union College and/or its agents the non-exclusive license to archive my thesis in whole or in part in all forms of media, now or hereafter known, and make it available for consultation on site at the Union College library.

I also grant Union College and/or its agents, under the conditions specified below, permission to make my thesis available online in whole or in part in all forms of media, now or hereafter known.

I also understand, if third part copyrighted matter is included in my thesis, and I have not obtained and attached hereto written permission for redistribution from the owner(s) of the copyright, that either that portion of my thesis or my entire thesis may not be made available online no matter what option I have selected below.

FERPA

To the extent this thesis is an educational record as defined in the Family Educational Rights and Privacy Act (FERPA) (20 USC 1232g), I consent to its release according to the specifications in this document. I retain all other ownership rights to the copyright of the thesis, including the right to use it in whole or in part in future works (such as articles or books).

INTERNET ACCESS OPTIONS

Open Access

Release the thesis for universal online access on a site maintained by Union College. Access to your thesis online serves the scholarly convention of sharing one’s research with others. It also exemplifies the nature of honors work done in your department or program.

Union Only

This option should be considered if you want access to your thesis for the Union community only.

Embargo Hold

In addition to one of access options above, you may also select an embargo period for your thesis if you a. believe there to be subject matter for which you wish to seek patent protection or b. if you plan to publish the thesis in a journal or some other medium at a later date. (One-year extension on request, if needed). Hold the thesis one year, then release for access on a site maintained by Union College.

Opt Out

Do not release the thesis for online access in any manner unless I provide written permission in future for so doing. The opt out choice should be selected if any of the following circumstances apply:

a.) There are co-authors, whose permission to publish the thesis has not yet been secured.

b.) The work and/or ideas of Union College Faculty are disclosed in the thesis and written consent to its publication has not yet been secured.

c.) Third party copyrighted matter is included in the thesis, and written permission for release has not been obtained and attached hereto from the owner(s) of the copyright.

You must still submit your thesis even if you select “Opt Out.”

Internet Access Selections*

Open_Access Union_Only Opt_Out Embargo_Hold

Indicate one access selection. Additionally, select Embargo Hold if you would like to apply an embargo.

Opt Out Additional Info

For information purposes only: If circumstance "c" above applies, but it is your sole reason for opting out and you would otherwise have chosen to release your thesis to the Union College community, please check this box.

STUDENT SIGNATURE

I have read and fully agree to the Union College Copyright Agreement regarding my thesis. I understand that there may be publishing and/or legal consequences to my selection of an access option. I agree to the option I selected above, subject to my advisor’s approval. If there are multiple authors, I have discussed these options with each of them and am choosing the option that we have agreed upon. I understand that if my advisor and I disagree, Union College will adopt whichever of our two choices is the more restrictive.

Signature*

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Use your mouse or finger to draw your signature above

Date*

THESIS ADVISOR APPROVAL

I have discussed the Internet Access options with my student(s), and I am aware of the choice my student(s) has made. I understand that if my student(s) and I disagree about the best choice, Union College will adopt the more restrictive of the chosen access options.

Thesis Advisor - Approval

I approve this choice. Another option is more appropriate.

Thesis Advisor - Alternate Choice

Open Access Union Only Embargo Only Opt Out

Opt Out Reason

There are co-authors whose permission to publish the thesis has not yet been secured. The work and/or ideas of Union College Faculty are disclosed in the thesis and written consent to its publication has not yet been secured. Third party copyrighted matter is included in the thesis, and written permission for release has not been obtained and attached hereto from the owner(s) of the copyright.

Thesis Advisor Signature*

[clear]

Use your mouse or finger to draw your signature above

Date *