The University of Southern Mississippi
118 College Drive #5024 Hattiesburg MS 39406
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 nursing 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
Student Name (First, Middle, Last): Student ID:
I am requesting an embargo of my thesis/dissertation/nursing capstone for the period indicated below.
6 months 1 year 2 years
More than 2 years
If longer than two years, indicate length. (Permanent
embargo's should be listed for 150 years.)
Reason for embargo:
I approve the request to embargo the thesis/dissertation/nursing doctoral project (Committee Chair):
I approve the request to embargo the thesis/dissertation/nursing doctoral project (Director of School):
To be completed by the Committee Chair or Director of School: A bound copy is required for the school files?
I approve the request to embargo the thesis/dissertation/nursing doctoral project (Student):
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.
This PDF form is fillable. Handwritten copies will not be accepted.
Thesis/Dissertation submitted to Graduate School and all requirements to be completed for:
Select one option:
Thesis/Dissertation submitted to Graduate School and all requirements were completed prior to: