University of Connecticut



THE UNIVERSITY OF CONNECTICUT

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OFFICE OF THE VICE PRESIDENT FOR RESEARCH

TECHNOLOGY COMMERCIALIZATION SERVICES

OPEN SOURCE RELEASE REQUEST FORM

The University of Connecticut, as the state’s publicly supported Land Grant University, has a three-fold mission comprised of Teaching, Research and Service. Creating software and putting it to use for the benefit of the public is one of many valid ways of contributing to the University’s overall objectives. Accordingly, The University of Connecticut encourages the inventive process and, through the Technology Commercialization Services group (TCS) of the Office of the Vice President for Research (OVPR), assists in bringing software to the point of public use.

PLEASE SUBMIT THE COMPLETED OPEN SOURCE RELEASE REQUEST FORM TO: Technology Commercialization Services, Office of the Vice President for Research, The University of Connecticut, 400 Farmington Avenue, MC-6400, Farmington, CT 06030-6400. Please e-mail the completed disclosure form (Word document preferred) to Christine McCluskey at: mccluskey@uchc.edu. Any documentation that cannot be transmitted electronically should be mailed. If you have questions, please call Technology Commercialization Services at (860) 679-3992. A member of TCS will contact you shortly to discuss your request.

PLEASE NOTE: ALL AUTHORS must complete and sign the AUTHOR SIGNATURE PAGE, which may be mailed to TCS after electronic submittal of an Open Source Release Request Form.

To ensure that you are completing the correct form, please begin by answering the following questions:

TRACKING FINANCIAL SUPPORT AND EXTERNAL COLLABORATIONS

1. Was the software developed in a “work-for-hire” capacity (i.e. were university-administered funds provided to individuals as compensation for developing the software/user interface and/or writing source code?)

No

Yes

2. Did the software result from a contract signed by or a grant awarded to the university?

No

Yes: If yes, please fill out the information below AND Questions 3 and 4.

Check the funding source(s) for the work that led to the developed software.

Type Agency/Company Grant/Contract No.

______ Federal ________________ ___________________

______ Industrial ________________ ___________________

______ Other ________________ ___________________

3. Is the software a deliverable of the contract or grant?

No

Yes: Please note that if yes, the University is empowered to assert an ownership interest in the software in order to be able to enforce the grant/contract.

4. Does the contract/grant/sponsor require open source release of the software/deliverable(s)?

No

Yes

5. Have you previously submitted an invention disclosure form in connection with this software and/or has a patent application related to the software been filed?

No

Yes

6. Do any author(s) have joint appointments or non-UConn affiliations?

No

Yes

If the answer to all of the above questions is “No” you may proceed with filling out the remainder of this form. Please note that commercialization opportunities can be pursued along with open source releases. If you feel that there may be potentially commercializable aspects of the software, please contact TCS Staff for further discussion in advance of any open source release.

If the answer to any of the above questions is “Yes”, please STOP filling out this form and contact TCS Staff for further guidance. You may need to complete the SOFTWARE/APP DISCLOSURE FORM instead.



THE UNIVERSITY OF CONNECTICUT

OPEN SOURCE RELEASE REQUEST FORM

| (1) LEAD AUTHOR’S |Department |Office Phone |email Address |

|Full Name | | | |

| _________________________________ |______________ |_______ |______________________ |

| | | | |

| | | | |

2) TITLE OF SOFTWARE:

3) BRIEF DESCRIPTION OF THE SOFTWARE:

4) OPEN SOURCE RELEASE – Part I – LICENSE SELECTION: Which Open Source License do you intend to release the software under?

For more information and guidance on Open Source License Selection and determining component compatibility please visit:



Please indicate the preferred license (select only one):

MIT

BSD 3-Clause

Apache 2.0

GNU GPL, Please specify version: _______________

GNU LGPL, Please specify version: _______________

GNU AGPL, Please specify version: _______________

Creative Commons, Please specify version: _______________

Other, Please specify: _______________

Non-commercial/research use only

Guidance requested

5) OPEN SOURCE RELEASE – Part II - LOCATION: Please indicate where the software is currently/will be housed (please mark all that apply):

Personal Website, Please provide the web address: _______________

Personal/Lab Website (UConn affiliated), Please provide the web address: ______________

Github, SourceForge, or other hosting provider (If Other, Please specify): ______________

Through a Federal Agency (e.g. NIH), Please specify: _______________

Through a Journal/Publication, Please specify: _______________

Other, Please specify: _______________

Please note that for Open Source release requests, the “Open Source Endorsement” section below must be completed. The endorsement signature should come from the department/center that has primary responsibility for funding and/or development of the software.

An “Author” is anyone who has written any portion of the software. Even small contributions to the code constitute authorship.

By signing below, each Author attests to the following:

1) As applicable, I have fully disclosed all of the third party code and materials that have been embedded in the software described in the present disclosure (as disclosed in the Supplemental Information Section of this form);

2) As applicable, I affirm that I have conducted a license compatibility assessment and to my knowledge, the licenses present in the software (as disclosed in the Supplemental Information Section) are compatible;

Note: The “Build of Materials” spreadsheet in the Supplemental Information Section of this form should be utilized in determining if components are compatible. Visit for further guidance.

3) I affirm that I have read the license selected in Section 4 and will, to the best of my ability, remain in compliance with the associated terms and conditions;

4) I am in agreement with the requested Open Source Release/distribution model stipulated in Sections 4 and 5 and agree to include the appropriate copyright statement, open source license file, and the General Disclaimer provided by TCS staff as part of any Open Source Release.

| |Author(s) Signature(s) |Affiliation |Department / Campus |Date Signed |

|1. |Signature: | | | |

|Print or Type Name: |Title (e.g. faculty, staff, student, contractor, etc.) |

|Home Address: | |

| | |

|E-mail Address: | |

|Nature of contribution (please briefly explain your contribution to the software, including if your participation is “work-for-hire” or if|

|you may be a non-author contributor): |

|2. |Signature: |Affiliation |Department / Campus |Date Signed |

|Print or Type Name: |Title (e.g. faculty, staff, student, contractor, etc.) |

|Home Address: | |

| | |

|E-mail Address: | |

|Nature of contribution (please briefly explain your contribution to the software, including if your participation is “work-for-hire” or if |

|you may be a non-author contributor): |

Open Source Endorsement

The request for Open Source Release has been reviewed and endorsed by the following representative with institutional signing authority:

Department/Center: ________________________

Department Chair/Center Head Name (print): ________________________

Department Chair/Center Head Signature: ________________________

Date: _______________________

SUPPLEMENTAL INFORMATION

THIRD PARTY CODE: Please list all third party code that has been used in this software. Please consider all propriety or open source code that is either embedded in or accessed by the software when it is executed. Any code not written by authors, including but not limited to, all open source code, library code, code written by colleagues, or other proprietary code should be listed below. Please feel free to add rows as needed.

“BUILD OF MATERIALS”

|Component |Web Page to Download Code |License [Version] |Web Page Location of Third Party|

|(Name of Third Party Code/Library) | |(e.g. Apache [2.0]) |License |

| | | | |

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