Submit by Email
UNCW Gerontology Program
Electronic Final Project Form
Student Name:
Student ID#:
850
Document Title:
Student Agreement:
I hereby certify that, if appropriate, I have obtained and attached hereto a written permission
statement from the owner(s) of each third party copyrighted matter to be included in my thesis,
dissertation, or project report, allowing distribution as specified below. I certify that the version I
submitted is the same as that approved by my advisory committee.
I hereby grant to UNCW and its agents the non-exclusive license to archive and make accessible,
under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all
forms of media, now or hereafter known. I retain all ownership rights to the copyright of the thesis,
dissertation, or project report. I also retain the right to use in future works (such as articles or books)
all or part of this thesis, dissertation, or project report. \\\\\\p
Student and Committee Agreement:
Part A. My advisory committee and I agree that the above-mentioned document be placed in the
ETD archive with the following status: (choose one)
1. Release the entire work immediately for access worldwide.
2. Release the entire work for UNCW access only for:
1 year
3 years, or
indefinitelly
3. Release the entire work for UNCW access only, while at the same time releasing only
the following parts of the work (e.g., because other parts relate to publications) for worldwide
access (separate files must be submitted to use this option): for
1 year,
3 years, or
indefinitely
Files named as follows (i.e., separate PDF or multimedia files):
4. Secure the entire work for patent and/or proprietary purposes for a period of one year.
During this period the copyright owner also agrees not to exercise her/his ownership rights,
including public use in works, without prior authorization from UNCW. At the end of one
year we may request, in writing, an extension for one additional year. At the end of the secure
period, the work will be handled under option 1 above, unless we request option 2 or 3.
1 year,
3 years, or
indefinitely
Part B. (Optional) For any release other than option 1, the Graduate School requests that you
name a proxy to cover cases such as if the student or committee signing this form becomes
inaccessible. Any of the following people (indicated by their names) is authorized to serve as
proxy for changes in availability. Submissions by any of these proxies signing are officially
recognized just as if the student and full committee signed. For example, it is suggested that the committee
chair be a proxy.
Printed name of proxy:
Printed name of proxy:
Review and Acceptance:
The final ETD of the above mentioned document has been reviewed and accepted by the student's
advisory committee. The undersigned agree to abide by the statements above, and agree that this
Approval Form updates any and all previous Approval Forms submitted heretofore.
Student
Signature
Student
Printed name
List Committee Members:
Chair
Member
Member
Member
TO BE COMPLETED BY GRADUATE SCHOOL STAFF ONLY
THESIS/DISSERTATION/PROJ.REP.
RELEASE OPTION
APPROVED BY
APPROVAL DATE
Date