Alabama Department of Archives & History

MICROFILM DUPLICATION ORDER FORM

Name : ______________________________________________________________________________________________________

Street Address (required for delivery): ____________________________________________________________________________________________________

City: ________________________________________________________________________________________________________

State: _______________________________________________________________________________________________________

Zip Code: ____________________________________________________________________________________________________

Country _____________________________________________________________________________________________________

Email address: ________________________________________________________________________________________

Phone Number (required to complete order): ________________________________________________________________________________________________

COPYING CHARGES

Cost per roll Number of rolls ordered Amount Due for Microfilm

Order

$25.00 $

International Orders add additional $10.00 for each roll

$__________________________

Order form checked and

Money received by ADAH staff member: ________________________________________________________


Send payment to:


The Alabama Department of Archives and History
Post Office Box 300100
Montgomery, Alabama 36130-0100
334-242-4363 ext. 254
http://www.archives.alabama.gov



Each order must list each microfilm roll separately and include the location number (M# or S#) for each roll. The M or S number is available from the microfilmed newspapers database at: http://www.archives.alabama.gov/newsmicro/search.cfm, or for probate records at http://www.archives.alabama.gov/localrecords/search.cfm
Please allow 6 - 8 weeks for your order to be filled.



TITLE OF COLLECTION DATE SPAN LOCATION NUMBER (M# or S#)


1. ____________________________________________________________________________________________________________

2. ____________________________________________________________________________________________________________

3. ____________________________________________________________________________________________________________

4. ____________________________________________________________________________________________________________

5. _____________________________________________________________________________________________________________

6. _____________________________________________________________________________________________________________

7. _____________________________________________________________________________________________________________

8.______________________________________________________________________________________________________________

9.______________________________________________________________________________________________________________

10. _____________________________________________________________________________________________________________

order sent date rolls received

FOR ADDITIONAL TITLES

TITLE OF COLLECTION DATE SPAN LOCATION NUMBER (M# or S#)


1. ____________________________________________________________________________________________________________

2. ____________________________________________________________________________________________________________

3. ____________________________________________________________________________________________________________

4. ____________________________________________________________________________________________________________

5. _____________________________________________________________________________________________________________

6. _____________________________________________________________________________________________________________

7. _____________________________________________________________________________________________________________

8.______________________________________________________________________________________________________________

9.______________________________________________________________________________________________________________

10. _____________________________________________________________________________________________________________

http://www.archives.alabama.gov/patowrk.html