Form 1A

THIS FORM MUST BE SIGNED AND RETURNED TO THE BOOKSTORE BEFORE YOUR COURSE PACK WILL BE PRINTED

Name_________________________ Summer email or phone______________________

Dept. ____________________________ Course # ____________________________

Estimated Enrollment___________ # of items to be cleared ____________ Date_______

I have determined that one or more items in my course pack need permission before being copied for class use. Please obtain this permission for each item I have indicated on the attached form(s) 1B.

I have determined that all items in my course pack are appropriate for educational fair use and may be copied without permission.

Signature ___________________________________________________________

Please choose one of the following options, then sign and return this form (with form 1B if you choose the second option) to the bookstore.