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BFCSC Reproductions Request and Agreement Form

Instructions
To order reproductions, please complete Sections A through C below. All sections must be completed. Missing information will delay completion of order. Please read our the BFCSC Reproductions and Permissions Policy carefully before submitting this form.
Section A. Statement of Agreement
(specify association, business, university)
Conditions for requesting reproductions
The above-named agrees to the following conditions for requesting reproductions from Georgetown University Library Special Collections Research Center (SCRC). • Reproductions made in response to the submission of this form are for personal research use only. • Reproductions are not to be deposited in any other library or repository. • Reproductions will not be published or used commercially without the written permission from the owner of the copy/literary rights of the original material and Georgetown University Library. The permission granted by Georgetown University Library to use reproductions of material held in SCRC does not constitute and may not be substituted for permission from the owner of the copy/literary rights, which it is the direct responsibility of the user to obtain. • All responsibility regarding copy/literary rights arising from the use of reproductions is assumed by the above-named. • Access to manuscript and archival material for any purpose involving pending litigation must be through the office of the University Counsel • SCRC is not responsible for damage or loss of reproductions sent by mail. • The above-named accepts all financial responsibility for reproductions made in fulfillment of this request.
SECTION B. Request for Reproductions
For billing and delivery information, refer to the Reproductions and Permissions Policy
Item 1
Item 2
Item 3
SECTION C. Signature of Agreement
Checking this box serves as your signature.