To order copy prints or images on CD, fill in and print this form, and mail with payment to address below. Checks and money orders payable to ADAH for the appropriate size and number of prints. Credit card payment also accepted.
To request permission to publish a photo, including on the Internet, please fill out a Permission to Publish form.
Notice: Warning Concerning Copyright Restrictions. The copyright law of the United States (Title 17, United States Code) governs the making of photocopies or other reproductions of copyrighted material. Under certain conditions specified in the law, libraries and archives are authorized to furnish a photocopy or other reproduction. One of these specified conditions is that the photocopy or reproduction is not to be "used for any purpose other than private study, scholarship, or research." If a user makes a request for, or later uses, a photocopy or reproduction for purposes in excess of "fair use," that user may be liable for copyright infringment. This institution reserves the right to refuse to accept a photocopy order, if, in its judgment, fulfillment of the order would involve violation of copyright law.
I agree to all the conditions set forth on this form. Signature: _______________________________
NAME: _______________________________________________Today's date_________________
ADDRESS__________________________________________________________________
CITY/STATE/ZIP_________________________________________________________________
PHONE NUMBER:_______________________________________EMAIL:_______________________
| Order number | Description of Image | Image on CD | Prints | |
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| PRINTS WILL BE SAME SIZE AS ORIGINALS UNLESS OTHERWISE SPECIFIED | Quantity | Subtotal |
| PHOTOGRAPHS ON CD (all images scanned at 600 dpi) $15.00 per image | ||
| PRINT PRODUCTION FEE (MATTE FINISH) | ||
| 8 x 10 or smaller ($15.00) | ||
| 11 x 14 ($28.00) | ||
| 16 x 20 ($50.00) | ||
| COPY NEGATIVE $ 10.00 each
(only necessary for prints of 11 x 14 or greater, if negative does not already exist) |
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| REPRODUCTION RIGHTS FEE - Commercial use fee $100.00 per image | ||
| Not-for-profit or educational use - No charge | ||
| RUSH ORDER FEE (includes $15 production fee) $ 50.00 per image
(two-day turnaround) |
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| REFERENCE FEE ($15 per image may be applied if full citation not provided) | ||
| TOTAL AMOUNT PAID *Payment must be received with order* | ||
Credit Card type ________________ # __________________________________________ Exp. date _____________ Name on card _______________________________________ |