Digital Reproduction Request Form
Montauk Library Archive Collection
Today's date
*
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Email
*
example@example.com
Phone number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization or institutional affiliation
Requested materials (Please include the library catalog call no., link to digital collection, or item name if available)
*
Intended use of materials
*
Personal/research purposes only
Educational use
Print publication
Online publication
Commercial use
Other
Please elaborate on the intended use of materials
*
Type of digital file requested
*
.JPG
.TIFF
.PDF
.MOV
.MP3
Requested resolution or file size
Deadline for requested materials (Please note requests may take 1-2 weeks to process)
-
Month
-
Day
Year
Date
Additional questions or comments?
I understand that use of this requested material is restricted to my above-stated intentions. Images must be credited "From the [Collection Name], Courtesy of the Montauk Library" and include the copyright: ©Montauk Library when applicable. All uses are for one time only and the rights are not transferable. A courtesy copy of any publication using ©Montauk Library images is greatly appreciated. I acknowledge that I have thoroughly read and understand the Montauk Library Archive Collection Access and Use Policy (https://tinyurl.com/MTKArchives).
*
Submit
Should be Empty: