_____________________________ (Name of Institution) hereby affirms that the
software package (circle one) GMS or SMS or WMS will be used solely for educational
purposes, as detailed below.
Please review the following statements and check the boxes to verify that you will comply:
I understand that the institution must forbid the use of software for commercial purposes, even if performed by institution employees, except as related to research contracts awarded to the institution. Should the software by used for any purpose other than the educational use expressly described below, we will be in violation of our Software License Agreement with Brigham Young University. Any such violation will be deemed a forfeiture of any special educational discount offer, and will result in our institution being charged the full purchase price of the software.
I certify that the institution named above has students and instructors, issues grades, and charges tuition.
I understand that the software license (purchased with an educational discount) belongs to the educational institution and should not be knowingly transferred to individuals leaving or no longer affiliated with the institution.
Please describe the anticipated use of the software in Section I and/or Section II below:
Section I. For use in classroom instruction:
* Name of course:
* Anticipated number of students:
* Semester taught:
* Brief description of course:
* How will the above software be utilized during this course?
Section II. For use in academic research:
* Name of project:
* Brief description/scope of project:
* How will the above software be utilized during this project?
Please review the following benefits which apply to academic license holders.
By purchasing one license at the academic rate, institutions determined to be eligible for the academic discount shall be entitled to the following special academic license privileges:
1. Two permanent passwords. Hardware locks may be purchased at prevailing prices in place of one or both of these passwords.
2. Temporary passwords for as many extra computers as needed in order to install
the licensed software in student computer labs can be requested. The passwords
will be good for no more than one year; however, they can be renewed or replaced
at no charge. The institution may alternately purchase a network hardware lock
(from 1 to 25 users) at prevailing prices to facilitate their student computer
lab.
On behalf of ___________________________________
(Name of Institution), I
hereby certify that the above information is complete and accurate.
Signed: ________________________________________ Date: ___________________
Type or Print Name: ______________________________________________________
Please complete the following for the primary technical contact (or user) of the software at your institution.
Name: _________________________________________________________________
Title: ___________________________________________________________________
Institution: _____________________________________________________________
Address: _________________________________________________________________
__________________________________________________________________________
Phone: _________________________________ Fax: ____________________________
Please send a printed copy
of the completed form to:
EMS-I - 1204 W. South Jordan Pkwy., Suite B - South Jordan, UT 84095
or Fax to: (801) 302-1160.