Course Reserves Media Digitization Request Form

PLEASE NOTE: 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. Any Cornell instructor may use this form to request streaming media for use with Canvas or Blackboard. In order for students to access e-reserve media, the instructor must first create a Canvas or 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 *

Blackboard or Canvas ID (e.g. 12345_2025FA_COMBINED-CROSSLIST)

Project Details

Needed by (NOTE: please submit at least 2-3 weeks in advance if possible, to allow time for recall or purchasing) *

Enter as mm/dd/yyyy, e.g. 12/08/2020

Titles (one title per line, please include "needed by" dates for each if different from above) *

Are subtitles needed?

Subtitle language(s) requested:

Are you requesting that the listed items be reactivated 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