Your Name/Name of chair:___________________________________/_______________

Project/Thesis Title_________________________________________________________

__________________________________________________________________________

I was in (circle if applies):     Title IV-E                   PPS program

I.                NOTICE RE: REPRODUCTION OF PROJECT/THESIS DOCUMENT (INCLUDING ABSTRACT) FOR ARCHIVE – ALL STUDENTS MUST PROVIDE A COPY OF THEIR PROJECT/THESIS ON DISK

I understand that the Department of Social Work Education (DSWE) at California State University, Fresno requires me to submit a copy of my project/thesis in digital/electronic format.  DSWE will make a digital/electronic copy of my project/thesis and the accompanying abstract for inclusion in a digital/electronic read-only ARCHIVE to be maintained by DSWE.  The purpose of this ARCHIVE is to document student work for administrative and programmatic reviews conducted by DSWE, the University and our accrediting body, the Council on Social Work Education (CSWE).  My signature indicates I have read and I understand the above notice.

____________________________________                        __________________

            (signature)                                                                               (date)

DSWE requests that you permit the additional use of the digital copy of your project/thesis in an electronic library as described below:

II.              AUTHORIZATION TO REPRODUCE PROJECT/THESIS DOCUMENT AND ABSTRACT FOR DIGITAL/ELECTRONIC LIBRARY

I give permission to the Department of Social Work Education (DSWE) at California State University, Fresno, to copy my project/thesis document and the accompanying abstract for the purpose of including it in a Project/Thesis digital/electronic read-only library.  The purpose of this library is to fulfill a professional responsibility to contribute to the professional social work knowledge base by making project/thesis documents available for use in research and classroom activities conducted by DSWE faculty and by future BA social work majors and MSW students.  I understand that:

1. Inclusion of my project/thesis document in the Project/Thesis LIBRARY is COMPLETELY VOLUNTARY.  Electing to exclude my project/thesis document from the library will have no effect on me academically or professionally.

2. The Project/Thesis digital/electronic read-only library is physically housed in the DSWE office; access to the library is controlled and limited to DSWE faculty and students.  Copies of the library on media such as a CD-ROM may only be used/reviewed in the department building (i.e., Psychology & Human Services Building); contents of the library may be posted to a secure internal department WEB site that is accessible ONLY by DSWE faculty and students. No part of the document, with the exception of the title page and author's name, may be disseminated without my permission through any medium (including the WEB) that can be accessed by the general public.

3. A database of abstracts from the projects/theses will be created.  Information about my project/thesis (limited to the title, author, chair/readers and abstract) may be published in DSWE media.  DSWE media may be disseminated within the department as well as to the University and the larger community.

4. Faculty and students may make a PRINT copy my project/thesis in part or in its entirety without obtaining further permission from me, on the condition that the requesting party assumes the cost of making copies and I receive proper acknowledgement of authorship. USERS WILL NOT BE ALLOWED TO MAKE PARTIAL OR FULL COPIES OF MY WORK IN DIGITAL/ELECTRONIC FORM UNDER ANY CIRCUMSTANCES.

Please initial or check the statement that indicates your wishes and sign and date (check only ONE [1]):

1.____ I authorize the reproduction and use of my project/thesis document as outlined above.

2.____ I authorize the reproduction and use of my project/thesis document as outlined above EXCEPT, I WITHOLD permission to include a copy of the ABSTRACT of my project/thesis in any document or electronic/WEB collection produced by DSWE for faculty, students, or the professional community.

3.____ I DO NOT give DSWE permission to include my project/thesis in the Project/Thesis digital/electronic read-only library.

_____________________________________                                  _______________

            (signature)                                                                                           (date)

______Check and complete information below if you wish to add this ADDITIONAL INSTRUCTION RE: PRINT COPYING FROM LIBRARY:

Permission to make a printed (paper) copy of this project/thesis in part or in its entirety must be obtained from me before copies may be made. The requesting party is responsible for obtaining permission from the author.  I may be contacted at: (please provide one of the following so readers may seek permission)

                 email:_______________________________________________________

                 telephone:____________________________________________________

                mailing address:________________________________________________
 

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