MRC Request/Waiver for Placing Instructor-Owned Materials on Course Reserve

I understand that the UCI Libraries will NOT be responsible for damage or loss of these materials.
I understand that the following will be taped on the packaging or piece of media itself: a call number label, bar code and date due slip. While these items will be removed as carefully as possible, some damage to the packaging may result.
I understand and agree that the Libraries will keep personal copies of media for no more than one academic quarter after the material is requested for course reserves. After trying to notify the owner at least once--if the material is not picked up within that time period--the Libraries reserve the right to discard the material.
In accepting media for reserve use, the library staff believes that such copies are legally obtained and in compliance with the UCI copyright guidelines.

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MRC Request Waiver
* Instructor:
* Email address:
* Work phone:
Other phone:
* Department:
Course number:
* Course title:
I would like to make a special request for the item(s) to be temporarily placed on Course Reserve for the period:
By clicking this button you agree to abide by the Terms of Media Use