Pratt Recording Release Form

Last revised: 4/17/07

Pratt School of Engineering

Duke University

RELEASE FORM
Please return to Course Instructor or Event Coordinator.

Your presentation, interview or notes will be recorded by a Duke student or instructor or by repre¬sentatives of the Pratt School of Engineering. This recording will be used in the normal conduct of classes at Duke and the files will be made accessible to students taking the class through streaming servers, Blackboard, class web sites, Duke’s page on iTunes or other mechanisms. Excerpts of the recording may be placed on Pratt’s and/or instructor’s web sites and may be accessed in the future by members of the Duke University community, faculty and staff at other institutions, or members of the general public. By signing this release, you give us the right to record your presentation, interview or notes for academic purposes at Duke and to include your presentation among one of our lecture series available to the public as a podcast through iTunes, or another other means of digital distribution. Interested parties will be able to download the presentation to their computers and/or portable devices.

In the event you want some part edited out of the presentation or interview due to proprietary content agreements or other limitations, please contact the instructor of the class within two weeks of your presentation or interview so that the material will not be used in web sites or other public venues outside of Duke classes. You must contact the instructor via email or other written communication. -------------------------------------------------------------------------------------------------------------------------------------------------

By initialing the statements below and signing this document, I hereby grant permission to record and use my interview/presentation.

___ (initial) I understand this presentation or interview will be recorded and that the full or excerpted recording will be used in streaming, shared audio files, and presentations in the class noted below.

___ (initial) I understand that this recording or excerpts thereof may be used for future streaming at the Pratt's web site or used in other media, such as DVDs, to promote Duke programs and/or instructional technology activities..

___ (initial) I have no objection to the use of my name, voice or image as they may appear in part or whole of the recordings, tapes or transcriptions of the resulting edited program.

___ (initial) I understand that Pratt acknowledges that I retain copyright in the presentation and in any associated presentation materials that may be distributed with this recording.

___ (initial) I give permission to Pratt to include the audio of this presentation as part of lecture series podcast which would be available for streaming or download to the general public.

___ (initial) I give permission to Pratt to include the video and audio of this presentation as part of lecture series podcast which would be available for streaming or download to the general public.

___ (initial) I give permission to Pratt to make my Power Point slides (or, other presentation files) available to an audience no larger than the scope I have approved for above with previous initialing.

Signature:

________________________________________________

Printed Name (as you would like it to appear on the recording labels):

________________________________________________

Printed Title (as you would like it to appear on the recording labels):

________________________________________________

Dept/Org (as you would like it to appear on the recording labels):

________________________________________________

Title of lecture (as you would like it to appear on the recording labels):

________________________________________________

Address:

________________________________________________

________________________________________________

Email:

________________________________________________

Phone:

________________________________________________

Date:

________________________________________________

Course/Instructor:

________________________________________________

Recorded by:

________________________________________________

(version: ms2)

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PDF icon Pratt Recording Release Form.pdf32.64 KB