Student Content Application

STUDENT CONTENT APPLICATION

Submission Date:

Student Information

I certify that I am 18 years of age or older and may grant the rights below without parental consent.

Parent / Guardian (If Student is Minor)

Content Details

Content Type: Video Audio Image Text Other:

Intended Use (select all that apply):

Institutional website Social media Promotional materials Curricular use Archival Other:

Geographic Distribution: Local National International

Permission Duration: Perpetual Limited until

Compensation: No compensation requested Compensation requested:

Rights Granted

By submitting this application and signing below, the applicant hereby grants to the Institution a license to use the submitted content in connection with the Institution's educational, promotional, archival, and operational activities. The scope of rights granted (select all that apply):

Non-exclusive Royalty-free Worldwide Reproduce Distribute Edit and adapt Create derivative works Public display/performance Sublicense to partners

Credit required: Yes

Representations, Warranties, and Third-Party Materials

The applicant represents and warrants that the submitted content is original to the applicant or that the applicant has obtained all necessary permissions, licenses and consents to grant the rights requested herein. The applicant further represents that the content does not infringe the rights of any third party, does not violate privacy or publicity rights, and contains no defamatory material.

Does the content include third-party materials (music, images, audio, text owned by others)?

Yes No

Indemnification and Liability

The applicant agrees to indemnify, defend and hold harmless the Institution, its trustees, officers, employees and agents from and against any claims, liabilities, losses, damages, costs and expenses (including reasonable attorneys' fees) arising out of or related to the applicant's breach of any representation, warranty, or covenant in this application, or arising from the Institution's authorized use of the submitted content.

Privacy, Data and Student Record Considerations

The Institution will handle personally identifiable information in accordance with applicable student privacy policies. By granting rights in this form, the applicant consents to the use of their name, likeness and biographical information in connection with the content unless otherwise indicated in writing below.

Academic Integrity & Certification

The applicant certifies that the content complies with academic integrity standards and institutional policies. The applicant acknowledges that submission of content for public use does not by itself convey academic credit unless otherwise specified by the course instructor.

I certify that the content is original or properly attributed and that I have complied with all applicable citation and copyright requirements.

Acknowledgment and Certification

By signing this application, the signatory acknowledges the representations, warrants the truthfulness of the information provided, and authorizes the Institution to use, reproduce, adapt and distribute the submitted content under the scope of rights selected above. If the signatory is a parent or guardian, the signatory represents they have the legal authority to execute this release on behalf of the minor student.

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