Notification Form for Using Copyrighted Material (Form A)

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.

 

Publication Name (e.g., IPSJ Journal Vol.42, No.1) :

 

Title :

 

Length in Pages :

 

Authors (All the authors must be listed) :

 

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 :

 

Date :

 

Name :

 

Affiliation :

 

Tel :

 

E-mail :