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Reproduction and Usage Request Form

Please carefully review our Photographic Services: Digital Scans, Photographs & Transparency Rentals page before completing this form. Complete lists of materials and permission fees are available on this page.

Please do not use this form to order photocopies.

Please use this form for the following uses:

  • to order digital scans, photographs, & transparency (already in stock) rentals, or
  • to apply for a licenseto reproduce AAS material

Directions for use:

  • To purchase a reproduction and obtain license for image use: fill out all sections
  • To request license for image: fill out sections 1, 2, 4
  • To purchase a reproduction without license for usage: fill out sections 1, 2, 3
  • Payment must be received before your reproduction order will be processed; please call or fax in a credit card number or request to be invoiced.

If you would prefer to fax or mail in your order, print an order form (pdf)


Date of request   * Date Reproduction Needed:
As time permits
Rush! Add 100% materials cost **

Payment Information
Please invoice me. I understand that my order will not be processed until payment has been received.
I will call or fax in my credit card number

*For mail order-- minimum postage and handling charge per order-- $7.00
Allow 2-4 weeks for digital photography and transparency orders; 4-8 for printed photographs.
**For rush orders add 100% materials cost. Please submit payment on day of order.


  1. Personal Information:

    Name Institution
    Street Address
    City State Zip Code
    Country
    E-Mail address
    Telephone Fax

  2. Image to be Used:

    Image title
    Artist name
    Book title
    Author
    Pages Date Call number
    Special instructions

    Image title
    Artist name
    Book title
    Author
    Pages Date Call number
    Special instructions

     

  3. Type of Reproduction: (ordering an image)

    Digital Image
    DPI
    size
    file information
    color glossy print
    black & white glossy print
    quantity
    color transparency*
    quantity
    *Color transparencies are only available for transparencies already in stock. Transparencies remain the property of the American Antiquarian Society and are rented for a two month period. Additional time must be negotiated with the AAS.

     

  4. Use of Image:

    printed work tv video/DVD film CD-ROM Internet publicity reference dissertation personal (non-published) exhibition

    Title of publication/production
    Author of publication/production
    Name of publisher
    Explanation

    The licensing agreement may be downloaded and printed, or sent to you by the Society. The license agreement should be signed and returned to AAS. It will be countersigned and returned to you once your payment is confirmed.

Additional information:

Any additional information we should know

Please note that the material fees and processing time are dependent on the availability of negatives and the format of the original material. Confirmation of order will be sent once order has been processed.

Payment must be received before your order will be processed.
We encourage payment by credit card, which may be faxed or called in. The Society accepts VISA, Mastercard, American Express, and Discover.

Contact Information

Rights and Imaging Coordinator
American Antiquarian Society
185 Salisbury Street
Worcester, MA 01609

Telephone: (508) 471-2126
Fax: (508) 753-3311
Email: reproductions[at]mwa.org


American Antiquarian Society
185 Salisbury Street
Worcester, Massachusetts 01609-1634
Tel.: 508-755-5221
Fax: 508-753-3311
e-mail the library

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Last updated April 15, 2009

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