EBE03 – DISSERTATION OPEN ACCESS SUPPRESSION FORM (EMBARGO REQUEST)

EBE03 – Dissertation Open Access Suppression Form (Embargo Request)

Note:

Only complete this form IF you require an embargo on your dissertation.
This form must be completed with the Intention to Submit form (EBE01).
This form should be completed and submitted along with your dissertation/ thesis if there is a need to prevent it being made available online via OpenUCT, for the reasons stated below.
Please see http://www.uct.ac.za/research/openaccess_content/ for further details on UCT's Open Access policy.
Please consult your supervisor if you are uncertain if an embargo is required.
If no embargo required, please leave the form blank.

Please complete the sections relevant to your selected embargo type:

Embargo type	Sections to complete
Intellectual Property (IP) / patent pending	Sections A and B
Sensitive content	Sections A and C
Publication pending	Sections A and D
Commercialisation	Sections A and E
Copyright of images	Pending

SECTION A: BASIC INFORMATION

Masters candidate name
Student number
E-mail address
Telephone number
Target hand-in date
Dissertation title
Department
Head of Department
Supervisor’s name
Co-supervisor’s name (if applicable)
Abstract (may be copied from thesis)
Type of embargo required	Type:	Tick
	Intellectual Property (IP) / patent pending
	Sensitive content
	Publication pending
	Commercialisation
	Copyright of images

SECTION B: INTELLECTUAL PROPERTY (IP) / PATENT PENDING

Please note that if you are requesting this embargo type, you would have initiated the process by completing the EBE02 (IP assessment form). No further action is required at this point. You will contacted should further information be required.

Period of suppression: 6 months blocks from confer date, up to 3 years maximum.

Method of suppression: The thesis will not be made available via OpenUCT until such time as the patenting process has been completed. Please note that the thesis title, your name and the abstract will not be suppressed and will be available via OpenUCT. Please provide a neutralised abstract as a separate .pdf document if the current abstract is not appropriate.

SECTION C: SENSITIVE CONTENT

Period of suppression: Please indicate your preferred period of suppression: ____________________________

Method of suppression: The thesis will not be made available via OpenUCT; a hard copy of the thesis will be lodged in the Special Collections section of the library.

Please note that the thesis title, your name and the abstract will not be suppressed and will be available via Open Access. Please provide a neutralised abstract as a separate .pdf document if the current abstract is not appropriate.

Additional documentation: Please provide details of the sensitive content and a motivation for the OpenUCT suppression request. These documents must be attached to this form when submitted.

Approval Authorities

Signature of candidate		Date
Signature of Supervisor		Date
Signature of Chair of the EBE EIRC	Faculty to obtain	Date
Signature of DVC	Faculty to obtain	Date

SECTION D: PUBLICATION PENDING

Period of suppression: Candidates of an option of 6, 12 or 24 months.

There is NO option for reducing or increasing the embargo period once approved.

Please select your preferred period of suppression:

Period	Tick
6 months
12 months
24 months

Method of suppression: The thesis title, your name and the abstract will not be suppressed and will be available via OpenUCT.

Approval Authorities

Signature of candidate		Date
Signature of Supervisor		Date

SECTION E: COMMERCIALISATION

Period of suppression: 2 years

Additional documentation: Please provide details and a motivation for the suppression request as a separate .pdf document. This motivation must be attached to this form when submitted.

Approval Authorities

Signature of candidate		Date
Signature of Supervisor		Date
Signature of Dean	Faculty to obtain	Date
Signature of DVC	Faculty to obtain	Date

04/07/2016 Page 3 of 3 EBE03

Tags: (embargo request), suppression, access, (embargo, dissertation, ebe03, request)