I/we request permission to reproduce the following image(s) from the collections of the Alabama Department of Archives and History.
CONDITIONS
b) In the case of motion picture films, filmstrips, and slideshows, the publisher agrees to send still photographs or photocopies of the title frame and the frame showing picture credits.
c) In the case of web sites or CDs, the publisher agrees to send images of the page(s) showing the picture and credit line.
PHOTOGRAPHS USED:___________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Title of proposed publication: ______________________________________________________________
Author/Producer: _____________________________________ Expected date of publication/release:________________
Address: ________________________________________
_________________________________ Telephone: _______________________
This use is: ___ Commercial ___ Non Profit ___ Educational (Check one)
The result will be: ___ Periodical ___ Book ___ Textbook ___ Film/Video ___ Web site/CD ___ Other (Check
one)
Distribution rights desired (one time, one language only):
___ North American rights ___ World rights Language: _______________
Other use: ______________________________________
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APPROVED _________________________________________________________ , Assistant Director for Public Services
DATE: ______________________________________ |