Fellowship Recipient Gallery Submission Procedure:
1. Complete the attached submission form electronically (as a Word .doc).
2. Save an electronic version and print off a hard copy and sign.
3. Submit an electronic version and signed hard copy to the SAIC Electronic
Communications office located in the Sullivan Center, room 1205, attention
Rae Ulrich.
Questions?
Contact the Electronic Communications office at 629-6131 or rulrich@saic.edu.
Fellowship Gallery of Work: Nonexclusive License Form
If you are providing work for your SAIC website gallery please provide the following
information.
The Artist
The “Artist” referred to in this License is:
Name
ARTIC ID Number:
CV and/or Web site url to include w/ profile:
Permanent Phone Number:
ARTIC Email Address (only) :
Department affiliation (for faculty and/or graduate students):
___ Art and Technology Studies
___ Art Education
___ Art History, Theory and Criticism
___ Arts Administration
___ Art Therapy
___ Ceramics
___ Fashion Design
___ Fiber and Material Studies
___ Film, Video and New Media
___ Historic Preservation
___ Liberal Arts
___ Painting and Drawing
___ Performance
___ Photography
___ Printmedia
___ Sculpture
___ Sound
___ Visual Communication
___ Visual and Critical Studies
___ Writing
Constituent type:
_X_ Student ___ Faculty ___ Alumni [ year graduated _____, degree received: ___________________ ]
Please note: if the work you are submitting was completed while you were a student at the school, you will be
listed under the student section of the profile and gallery sections.
Program affiliation:
Undergraduate:
___ Bachelor of Arts (BA) in Visual and Critical Studies
___ Bachelor of Fine Arts (BFA) in Studio
___ Bachelor of Fine Arts (BFA) with an Emphasis in Writing
___ Bachelor of Fine Arts (BFA) with an Emphasis in Art History, Theory, and Criticism
___ Bachelor of Fine Arts (BFA) with an Emphasis in Art Education
___ Bachelor of Interior Architecture (BIA)
___ Consecutive Degree Option for BFA and BA in Visual and Critical Studies
Fellowship Gallery of Work: Nonexclusive License Form – page 2
Graduate:
___ MFA in Studio; Department admitted into: __________________________________________
___ MFA in Writing
___ MA in Modern Art History, Theory, and Criticism
___ Master of Architecture NEW!
___ MA in Art Education
___ MA in Teaching
___ MA in Art Therapy
___ MA in Arts Administration and Policy
___ Master of Interior Architecture NEW!
___ Master of Design in Designed Objects NEW!
___ MA in Visual and Critical Studies NEW!
___ MS in Historic Preservation
___ Dual degree in MA in Modern Art History, Theory and Criticism and MA in Arts Administration
Post-Baccalaureate Degrees:
___ Post-Baccalaureate Certificate in Studio
___ Post-Baccalaureate Certificate in Writing
___ Graduate Certificate in Art History, Theory, and Criticism
Fellowship Gallery of Work: Nonexclusive License Form – page 3
Since you provided a description of your work with your Fellowship Application you will
not need to include a description of your work. You will only need to sign the License
section below. If you would prefer to include a description of work sheet please do so
electronically with your other materials on disk.
License
In support of its charitable and educational mission and for good and valuable consideration, the Artist hereby
grants to The School of The Art Institute of Chicago (the “School”) the non-exclusive, royalty-free rights to
reproduce the Work (the “License”) for the life of its copyright and any renewals or extensions thereof in any
media now known or not yet invented (all such reproductions referred to herein as the “Images”), and to display,
transmit, publish and otherwise use the Images throughout the world for its charitable and educational purposes.
In the case of audiovisual works, this License shall include a grant to the School of the non-exclusive, royalty-free
rights to publicly perform (screen) the Work on its own premises or elsewhere, throughout the world, including on
the Internet.
This License expressly authorizes the School to sublicense the specific rights granted herein to third parties,
including to its affiliates, as necessary (in the discretion of the School) to fulfill its mission. For all other rights
(including for any commercial use), the Artist understands that the School shall seek additional permission from
the copyright owner or such owner’s representative and that it will direct inquiring third parties to do the same.
The Artist certifies that neither the Work nor its contents violate the copyrights of any third parties.
Copyright
I affirm that I am able to grant nonexclusive license, as requested herein, because (please initial one):
_____ I am the creator of the Work and I have never transferred exclusive rights to the Work to any other
person or entity.
_____I am an heir of the creator of the Work or of a subsequent copyright owner and I have, in turn,
inherited ownership of the copyright, or a portion thereof, in and to the Work.
_____ I am the lawful assignee or exclusive licensee of the copyright to the Work as the result of a lawful,
written transfer.
In addition, please indicate if you are the sole copyright holder or a joint copyright holder (please initial one):
______I am the sole copyright owner.
______I am a joint copyright owner.
Fellowship Gallery of Work: Nonexclusive License Form – page 4
Copyright Notice
The Artist asks that, whenever feasible, the School include (and cause others to include) the following copyright
notice, or one similar to it, in connection with the Images (please initial one):
_____ © 200_ ___________________________ [Artist’s Name]
Other. (Please specify below)
IN WITNESS WHEREOF, the undersigned, intending to be legally bound, has duly executed this agreement on
the date set forth below.
Signature
Date