Permission To Publish Request Form

Permission to Publish Request Form

Information: Please read the full details about collections and criteria for using this form.

Process: To publish an image from HMML’s digital library, complete the online form below.

Fee: $25 processing fee, plus $1 per image to provide copies for publication; invoice will be issued, payable upon receipt. You will be notified in advance if any additional fees are owed directly to partner libraries prior to publication.

Questions: Email hmml@hmml.org; replies made within 7-10 business days.

User Information

Name (required) *

Email Address (required) *

Telephone Number (required - ex. 5551118888) *

Title/Position

Institution

User Address

Address Line 1

Address Line 2

City

State

Postal Code

Country

Manuscript Information

Manuscript Country

Manuscript City

Owning Library

Shelfmark (if known)

Folios (if known)

HMML Project Number

Brief Description of Content

Use Details

Author or Editor

Title of Publication

Publisher

Estimated Print Run

Publication Date

Intended Use

How or where will the image(s) be used?

Multiple Use Intended

Will the image(s) be used multiple times? In separate end products (i.e. journal and book)?

Agreement

User of requested images agrees to cite the owning institution, as well as the Hill Museum & Manuscript Library (HMML), Collegeville, MN, in any publications referring to these images and/or their content
User is permitted the use of the photographic copy only once, and only for the purposes listed in this agreement. Any subsequent or different use (including subsequent editions, book club editions, paperback editions, different languages, etc.) constitutes a reuse and must be applied for in writing
User must submit two copies of any published work containing references to HMML's microfilms or digital images to HMML (one copy will be forwarded by HMML to the owning institution)
User understands that the image is copyrighted and that it may not be used for any purpose other than private study, scholarship, or research without obtaining the signed authorization of the copyright holder
User assumes all responsibility for questions of copyright and invasion of privacy that may arise in copying and in the use made of the photographic copy
Requests for use will be forwarded to the owning institution for permission and possible fees
In authorizing the publication of a photographic copy the owning library and HMML do not surrender their rights to publish the image or images, or to grant permission to others to do so
Permission does not permit others to reproduce the photographic copy or any facsimile of it
By completing the electronic signature below you agree to these terms

Electronic Signature (required - type your name)

Comments

Permission To Publish Request Form