Media Consent Form B ‑ Submitted Media Items to Dalhousie University

 
 I understand and consent


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A. Personal Information (This information is protected, and will never be used for any other purpose.)

 
 
 Faculty
 Staff
 Student
 Other
 
 
 

 

B. Media Item Details (Please be as specific as possible. This information is required to specifically identify the media item, including details about the subject and setting, and technical details such as filename, format, and equipment used.)

 
 
 Photograph
 Video
 Audio
 Other
 
 Administrative: Made available or used within Dalhousie. Example uses: ID cards, printed directories or handbooks, intranets or private websites
 Publications: Made available or used externally on a not-for-profit basis. Example uses: marketing and promotional material (brochures, DVDs, videos, websites), annual reports, media releases, magazine articles.
 Internal Education: Made available or used for educational purposes (including lectures, workshops, tutorials, lab or clinical skills demonstrations, grand round presentations) within Dalhousie. Example uses: tutorial case exhibits, lecture handouts, DVDs or videotapes on library reserve, internal media or learning objective libraries.
 External Education: Made available or used for educational purposes external to Dalhousie on a not-for-profit basis. Example uses: external media or learning object libraries, journal articles, international projects.

D. Other limitations on Use (Please list other limitations, such as time limits on use, in detail below)

 
 
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