Course Reserves Media Digitization Request Form

PLEASE NOTE: Each form submission is valid for the current course and semester only; a new form must be submitted for each item, each semester that the item will be used.

Any Cornell instructor may use this form to request streaming media for use with Canvas. In order for students to access e-reserve media, the instructor must first create a Canvas site via Faculty Center. If you have any additional questions about this form or about streaming media reserves, please contact us at culmediareserves@cornell.edu.

Instructor Info

Instructor Name *

NetID *

E-Mail *

Phone

Course Info

Course Number and Section *

Course Name *

Semester *

Canvas SIS ID#

Found in the "Settings" section of the Canvas course page

Project Details

Title *

PLEASE NOTE: only ONE title may be included in each form submission. If requesting multiple items a separate form must be sent for each title.

Needed by date: *

Please submit at least 2-3 weeks in advance to allow time for recall or purchasing.

Are subtitles needed?

Subtitle language(s) requested (please note that language options may be limited to what is available on the library-owned copy):

Languages

Section Needed

If there a specific portion of the film needed for instruction, please provide the start and end timestamps in h:mm:ss format.

If you require the full film for instruction, please state the research & scholarly purpose for utilizing this film in your course.

Full Film Needed

During which week in the semester will this be viewed by students? *

Are you reactivating this title from a previous semester or course? *

Other instructions/notes:

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

Course Reserves Media Digitization Request Form

Services

Olin & Uris Libraries

Website

Olin Library

Uris Library

Information and reference

Circulation