Application for Academic Teaching License

What is an academic teaching license? An academic teaching license is available to use the DILIsym® software for instructional use ONLY and NOT for research purposes. For the academic teaching license, instructional purposes include student instruction, student demonstrations, and student projects, as part of a current course offering at an accredited college or university.

How many users will be covered under the academic teaching license? Academic teaching licenses are available for a single end user or for group use. A single end user license limits use of the software to a single user to be used at only one location at a time. A group license provides use to several qualified users at a single institution and for multiple workstations simultaneously.

What are the eligibility requirements?

1) Proof of employment by an accredited, degree-granting college or university;

2) Verification that Software will be used only for instructional purposes ONLY and NOT for research purposes (e.g., web address (URL) for a current course listing, course description, how many students enrolled in the class, and how the software will be used in class); and

3) Acceptance of DILIsym Services' Academic License Agreement: Academic License Agreement

4) Payment of a license fee

Please complete this application carefully and completely, as it is used to determine your eligibility. If the application is incomplete when received, it will be disregarded. Information marked with “*” is required in order to process an application. Review time may take at least 2 weeks, due to the large volume of requests. We will notify you, the Instructor, if your application has been accepted, and at that time will discuss any further considerations prior to you formally signing the Academic Teaching License Agreement.

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* Required information.

Submitter Details

Name of University *
Department / Site *
Address *
City *
State / Province *
Postal Code *
Country *

Instructor

Name *
Title *
Email *
Phone *
Faculty Profile * web address (URL) of Principal Investigator’s official faculty profile on university website

Course

Course name *
Course website * web address (URL) for the course's website is for verification of the course status
Course Description * include details of the subject matter to be taught, how Software will be used in the course; how many users of the Software; what is the goal of using the Software in the course
Intended Use * provide detailed description of how you or your research group will use the Software in research; names,  titles, department, and contact info of investigators in your research group who will use the Software.
Funding Sources and Intellectual Property Rights * list external funding sources for the academic research for which you intend to use the Software; and list any individual or entity which would gain intellectual property rights generated by use of the Software in the academic research.  If the answer is none for either, please indicate “none” for the appropriate question
Commercial Interests * list and describe any and all commercial entities or third parties<br/>that would benefit from the research for which you intend to use the Software, or from the use of the<br/> Software by you or your research group

Course Dates

Course Start Date *
Course End Date *
Additional Comments Please include here any additional information that you think is pertinent to the processing of your application
I accept the Academic License Agreement
Accept Agreement *

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