Application For Permission To Publish or To Release Media

Please see verso of form for Archives and Special Collections policies regarding permission to publish or release media created from Special Collections materials.

Name of Applicant: _______________________________________________________

Address: ________________________________________________________________

Phone: _________________________________________________________________

Describe item(s) you wish to employ. Identify collections, where pertinent, and describe material precisely, specifying images or excerpts to be used. Attach additional sheets if necessary.

Publication or media release Information:

Author, Editor, Producer, etc.: _________________________________________

Title: _____________________________________________________________

Publisher/Distributor: ________________________________________________

Expected Publication/Release Date: ____________________________________

Signature of Authorized Applicant: ___________________________________________

Date: ___________________________________________________________________

Mr. and Mrs. James R. Getz Archives and Special Collections

Donnelley and Lee Library, Library and Information Technology

555 N Sheridan Rd

Lake Forest, Illinois 60045-2399

amiller@lakeforest.edu, 847-735-5064; vignocchi@lakeforest.edu, 847-735-5071

Mr. and Mrs. James R. Getz Archives and Special Collections

Donnelley and Lee Library, Lake Forest College

Policies Regarding Permission to Publish or To Release Media

Patrons are required to request permission from the Archivist and Librarian for Special Collections to publish or to release media created employing the contents of Archives and Special Collections materials.

To the extent that it may do so, Lake Forest College will ordinarily grant one-time publication and media production rights to applicants. In granting single-work permission to publish or to produce media, Lake Forest College does not surrender its own right to publish or to release media created from materials in its collections or to grant permission to others to publish them.

If single-work, one-time permission to publish or to release media is granted, the location of the cited material must be indicated in the published work. Please cite as [specific] collection, Archives and Special Collections, Lake Forest College Library.

A copy of all publications or media works that rely heavily on the collections of Archives and Special Collection, Lake Forest College Library, should be donated to the Library upon publication or release.

Lake Forest College does not assume responsibility for infringement of copyright in the material held by others.

For further information or queries, please contact

Arthur H. Miller

Archivist and Librarian

For Special Collections/LIT

Lake Forest College

555 North Sheridan Road

Lake Forest, IL 60045-2399

847-735-5064 voice, -6297 fax

amiller@lakeforest.edu

May, 2008