6 months 1 year 2
years
Embargo Agreement
The University of Southern Mississippi
Graduate School
118 College Drive #5024 Hattiesburg MS 39406
This PDF form is fillable. Handwritten copies will not be accepted. Submit completed form via email to documentspecialist@usm.edu.
An embargo will allow you to restrict public access until the embargo expires. Discuss with your committee chair whether or not an embargo
is appropriate for you. If you embargo your thesis, dissertation or doctoral project, it will not be available in Aquila until the end of the
embargo period. The title, abstract, attribution information, and subject classification will be available during and after the embargo in the
USM Library Catalog. Please complete the applicable section(s), secure appropriate faculty approvals, and file this form with the Graduate
School.
Date:
Student ID:
Emphasis:
More than 2 years
If longer than two years, indicate length. (Permanent
embargo's should be listed for 150 years.)
In the event you want to extend your embargo past the period indicated above, you will need to:
1. Resubmit this form reflecting permission from your Committee Chair and Director of School;
2. If submitted document through ProQuest or another database, you will need to directly contact them to extend embargo.
This should be done after approval is granted from your Committee Chair and Director of School.
Reason for embargo:
Signatures
I approve the request to embargo the thesis/dissertation/doctoral project (Student):
I approve the request to embargo the thesis/dissertation/doctoral project (Committee Chair):
I approve the request to embargo the thesis/dissertation/doctoral project (Director of School):
To be completed by the
Committee Chair or Director of School: Is a bound copy required for the school files?
Updated August 2019
Student Name (First, Middle, Last):
Degree:
Title of thesis, dissertation, or doctoral project:
What semester was your thesis, dissertation, or doctoral project submitted to the Graduate School?
I am requesting an embargo of my thesis/dissertation/doctoral project for the period indicated below:
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click to sign
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