Wheelock College Library Archives Permission to Publish/Use Form

WHEELOCK COLLEGE LIBRARY ARCHIVES – PERMISSION TO PUBLISH/USE FORM

Instructions: Please read this form thoroughly (two printed pages). Print and complete

one copy. Send this copy with appropriate signatures to

Wheelock College Library

ATTN: Archives

132 The Riverway

Boston, MA 02215

Please include your return address. A countersigned copy will be returned for your records.

Permission to Publish/Use Form

Name of person/organization: ______

Address: ______

Telephone: ______Email: ______

Subject to the conditions listed below (page 2), I request permission to publish or otherwise use the following material from the collection of the Wheelock College Archives:

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This material will be included in: (If a publication, include title, publisher, and date of

publication)

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For use in digital or web-based products, please describe the context of use, length of “run”, and clarify whether the final product will be public or private.

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Conditions for Use of Material

1.  Proper credit ("Courtesy of the Wheelock College Archives: www.wheelock.edu/library") must always be given. The person, organization, or company requesting permission to publish is responsible for the credit line. If this image or these images are being used by a for-profit agency, the Wheelock College Archives reserves the right to charge a fee for use.

2.  Permission is granted, in advance, for one time use only. Reuse or resale is not allowed without specific authorization by the Wheelock College Archives.

3.  Permission to publish or otherwise use material is contingent upon completion of this form.

4.  All material is retained in the Wheelock College Archives and is never circulated or loaned for publishing purposes.

5.  Photographic or digital negatives of Wheelock College Archives materials made at a patron's request are the property of the Wheelock College Archives.

6.  The Wheelock College Archives does not claim to control the rights of reproduction and distribution for material in its collection. The publishing party assumes responsibility for all infringements of copyright and invasion of privacy.

7.  In authorizing publication of any material, Wheelock College Archives does not surrender its own right to publish or grant others permission to do so.

8.  One complimentary copy of the publication will be given to the Wheelock College Archives.

9.  The Wheelock College Archives reserves the right to alter these policies without prior notice.

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Name (Print)

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Name (Signature) Date

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Representative of the Archives Date

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Director of Academic Resources and Library Services Date