AGSA Image Request Form
Applicant Details:
Full Name
*
First Name
Last Name
Name of organisation (if applicable):
ABN - Australian Business Number (if applicable):
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Format: (000) 000-0000.
E-mail
*
example@example.com
Details of the Work(s) of Art (specify name of artist and title of work):
*
Please note additional fees may apply if new photography is required.
Proposed use of Work/s of Art
*
Exhibition catalogue
Publication
Merchandise
Film/Television
Website/Social Media
Other
If selected other in the above question please specify the intended use:
Enter in relevant project details:
*
E.g full title of proposed project; author/editor's name; estimated retail price of project; print run; anticipated date of publication; distribution (Australia or Worldwide)
Date image is required:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
If new photography is required, it may take up to 12 weeks to have the images ready
Use of image (please select one or more):
In text, whole image
In text, detail
Cover or dust jacket
Other
Type of image required:
*
300 DPI Tiff File (High Resolution)
JPEG (Low Resolution)
(If relevant) Has copyright been obtained by the relevant copyright holder:
*
Yes
No
Provide relevant details of copyright approval from copyright holder:
*
Please note that approval from the copyright holder must be obtained for all works still in copyright. In most cases, copyright will remain active for 70 years after the death of the artist.
Applicant Signature
Submit
Submit
Should be Empty: