Any Cornell instructor may use this form to request streaming media for use with Blackboard. Each form submission is valid for the current course and semester only and a new form must be submitted each semester that the item will be used. In order for students to access e-reserve media, the instructor must first create a Blackboard site via Faculty Center. If you have any additional questions about this form or about streaming media reserves, please contact us at okureserve@cornell.edu. Instructor Info Instructor Name * NetID * E-Mail * Phone Course Info Course Number and Section (e.g. ENGL 1234.101) * Course Name * Semester * Fall Winter Spring Summer Blackboard ID (e.g. 12345_2025FA_COMBINED-CROSSLIST) Project Details Needed by (NOTE: please submit at least 2-3 weeks in advance to allow time for recall or purchasing) * Year20182019 Year MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Titles (one title per line, please include "needed by" dates for each if different from above) * Are subtitles needed? Yes No Subtitle language(s) requested: Are you requesting that the listed items be reactivated from a previous semester or course? * Yes No Other instructions/notes: Copyright Acknowledgement One of the three boxes below must be checked by the instructor as true: * I own the copyright to this material or it is in the public domain I have obtained permission from the owner of the copyright of this material to make a copy I have conducted a fair use analysis and have determined that the use of this material meets fair use guidelines (please refer to the Fair Use Checklist) DMCA Exemption The Digital Millennium Copyright Act makes it unlawful to circumvent access control measures used on DVDs regardless of the copyright status of the work, but an exemption to this Act is available if all of the following conditions are satisfied. All four boxes below must be checked by the instructor as true: * The media is owned by the library (or I am requesting its purchase) and is therefore lawfully made or acquired, and The media is a DVD or VHS copy (or audio) and NOT Blu-Ray, and is therefore either protected by the Content Scrambling System "CSS" or is not copy-protected, and Confirm DMCA 2 * High-quality reproduction is needed for the desired criticism or comment that cannot be satisfied with non-circumventing methods such as screen capture, and Confirm DMCA 3 * Short portions of the digitized work will be incorporated into a new work (e.g., this course) solely for educational uses requiring close analysis of film and/or media excerpts. Confirm DMCA 4 * Notice By submitting this form I affirm that my usage of the digitized content meets both copyright requirements and all necessary conditions for exemption from DMCA restrictions. I understand that this form is valid for the current course and semester only and I must submit a new form each semester that the media will be used. I understand and agree. I understand and agree with the above * Leave this field blank Submit
