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Exclusive copyright
Arrival date: 1 June / 1 December Session:

School number: School name:

Refer to the Handbook of procedures for the Diploma Programme before supporting a candidates claim.

- Please retain a copy of this form either using the Save as function or by printing a copy.
- Identify the component for which the candidate claims exclusive copyright.
- Send the completed form to School Assessment Services (ibisadmin@ibo.org) to arrive at the latest by 1st June / 1st
December one month before the issue of results for the examination session concerned. (Please note that this form can be
submitted under the appropriate heading using the 'contact us' option on IBIS).
- After completing this form it must be printed and then signed by the candidate and coordinator.

Candidate name:

Candidate session number:

Subject/ theory of knowledge /

Level Component (please specify) *
extended essay / Reflective project

* For example, written assignment, studio work

Candidate's signature: Date:

Coordinator's name:

Coordinator's signature: Date: