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Class Software Information and Agreement Form

Print out this form and mail it to:

Multimedia Center
Marriott Library
The University of Utah
295 S. 1500 E.
Salt Lake City, UT 84112-0860

Course Information

Instructor's Name  
Campus Address and Phone

 

 

 
Instructor's E-mail Address  
Department/College  
Course Title / Section  
Estimated Number of Users  
Estimated Hours of use per user  
Requested Install Date  
Earliest Removal Date  
Target lab(s)  


Software Information

 

 

 


Special Instructions

Software Title  
Software Vendor  
Vendor Tech Contact (if known)  
Vendor Sales Contact (if known)  
Vendor EMail  
Vendor Phone  


License Agreement

I, the undersigned, acting on behalf of the University of Utah Department of College listed above, have secured the necessary licenses and/or permission to install the above mentioned software product for access in the above specified Student Computing Lab(s). I (or my department/college) assume all responsibility and/or liability resulting from any use of the software in the specified lab(s). I have read, understand, and agree to abide by the University of Utah SCL policies listed above.

Date: ________________

Name (printed): ____________________________________________________

Signature: ________________________________________________________

Title: ____________________________________________________________