Art Request Form
Applicant/Borrower General Information
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Department (Internal) or Occupation/Institution (External)
Request Type
Request for a campus art loan
Request art for research
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Request for a Campus Art Loan
Title
Please the provide the full title and catalog number of requested work,
found here
.
Location Information
Department
Campus
Please Select
Medford/Somerville
Boston / SMFA at Tufts
Grafton
Boston Health Sciences
Building Name and Address
Room Number
Type of Space
Private office
Conference room
Reception area
Other
Please provide a brief description of the space where the artwork will be displayed.
Is the space locked when not in use?
Yes
No
Is this space monitored when open?
Yes
No
Environmental Conditions
Please note any features in the room that could potentially emit moisture or heat (radiators, pipes,window A/C units, etc.) and their proximity to the where the artwork will be hung.
Will there be direct sunlight on the artwork at any time of day?
Yes
No
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Submit
Next
Request Art for Research
Title
Please the provide the full title and catalog number of requested work,
found here
.
Please provide a short description of your research objectives and how the work will be used.
Viewing Date (First Choice)
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Viewing Date (Second Choice)
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Viewing Date (Third Choice)
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Submit
Should be Empty: