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.

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.

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    Date                           Signature of Applicant

Name ______________________________________________________________________

Address ___________________________________________________________________

Phone ________________________________   Fax ______________________________

Affiliation/Purpose _______________________________________________________

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Items _____________________________________________________________________

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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).

Place of publication, including website ___________________________________

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Procedures

HSU Library Special Collections staff take the materials to the appropriate place to be duplicated and retrieve them.
Applicant pays fees established by the vendor directly to the vendor when receiving the copies.

HSU Library Special Collections Approval:

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       Signature                               Date