Please complete this form requesting permission to use copyrighted material (images, video, etc.) held by the National Center for Supercomputing Applications (NCSA). If your request is approved by the Board of Trustees of the University of Illinois through NCSA (“Grantor”), Grantor will sign and return this form to the individual/organization requesting the material (“Grantee”). In signing, Grantor represents that Grantor is the sole owner of the material and that Grantor has all rights necessary to grant such permission in the form of a non-exclusive, revocable license.
If you have questions, please contact email@example.com.
Grantee may not modify requested material without express written permission from NCSA.
Material may be used only for the purpose stated in this request. Material may not be sublicensed to any other entity or individual. Grantee agrees to submit a sample of the completed work to NCSA with the date of publication. Grantee grants permission to Grantor to display the sample on Grantor’s website(s) to publicize and promote the use.
This form approved by University Legal Counsel February 5, 2020. Any revisions to this form other than Grantee-provided information will require University Legal Counsel review and approval.