Notification Form for Using Copyrighted Material (Form A)

Please return a completed form to IPSJ via FAX (+81-3-3518-8375), email (editj [at], or snail mail

To: Information Processing Society of Japan
Based on IPSJ Copyright Guidelines Article 5, Part 2, I, the author of the copyrighted material below, hereby notify the use of the material as specified below.

(1) Copyrighted Material to be Used

Publication Name (e.g., IPSJ Journal Vol.42, No.1) :
Title :
Length in Pages :
Authors (All the authors must be listed) :

(2) Purpose of the use (Check one)

Reprint in another publication :
Publication Name :
Publication by a publisher (IPSJ and the publisher will make a contract on the use of the material) :
Publisher :
Contact :
Reprint / Distribution :
Purpose :
Others :

(3) Person filing this notification

Date :
Name :
Affiliation :
Tel :
E-mail :