Humboldt Room Duplication Application

HSU Library Humboldt Room Application for Duplication
Conditions
1. Duplication, in whatever format, e.g., photocopy, photograph, copy print, scanned image, is made available solely for the reference use of the applicant.

2. In making this copy available, the HSU Library does not thereby grant permission to reproduce or quote extensively for publication or to display on the world wide web. Requests for such permission must be submitted in writing with sufficient lead time for processing (see below).

3. When material from the HSU Library's Special Collections is published, including on a web page, acknowledgement of permission to publish and credit for the possession of such material must be noted in the work. The credit line should read as follows: (Name of collection), Humboldt State University Library.

4. The HSU Library does not, by making copies available or by granting permission to publish or to quote therefrom, relinquish its own right to publish the material or to permit other persons to publish or quote therefrom.

5. The applicant assumes full responsibility for any infringement of copyright or publication rights belonging to the author, his heirs, or assigns.

Terms of Agreement *

I have read the above conditions under which the requested material is made available to me by the HSU Library and I agree to abide by them. I assume all costs (see below) related to this service.

Required

Date *

YYYY

Full Name *

Your answer

Street Address *

Your answer

Phone Number *

Your answer

Email address *

Your answer

Affiliation/ Purpose *

Your answer

Request to Publish. A use fee of $50/image is charged for commercial publication purposes, payable to Humboldt State University Library. This fee is for a one-time use of the image(s). HSU will release the image(s) when the payment is received. *

Place of publication, including website

This image is for research purposes only. I do not plan to publish at this time.

I plan to publish this image in a non-commercial publication. (Type place of publication below)

I plan to publish this image in a commercial publication. (Type place of publication below)

Other:

Item Number(s)

List all the items you are requesting. List [title of object]- [photo id number] Example: Group poses in front of Redwood Log- 1234.56.7891

Your answer

Resolution

If you need a particular image resolution, please indicate here

300 dpi

600 dpi

Other:

File Type

If you need a particular format, please indicate here

jpeg

tiff

pdf

Submit

Never submit passwords through Google Forms.

This form was created inside of Humboldt State University. Report Abuse - Terms of Service

Forms