MIT Copyright Amendment form
This page has a self-description that says it best:
"Developed at MIT, this amendment is a tool authors can use to retain rights when assigning copyright to a publisher. It will enable authors to continue using their publications in their academic work at MIT, to deposit them into the MIT Libraries' DSpace repository, and to deposit any NIH-funded manuscripts on the National Library of Medicine's PubMed Central database."
http://libraries.mit.edu/about/scholarly/copyright-form.html