NAME(s): ________________________________________________________________________________

ADDRESS:________________________________________________________________________________
(street or P.O. box, city, state, and zip code)

PHONE: (______) ______ __________

DESCRIPTION OF MATERIALS LOANED FOR REPRODUCTION:
 
 
 
 
 
 

INFORMATION CONCERNING THE COLLECTION, LENDER, ETC.
(to assist staff in arranging and describing the Materials):
 
 
 
 
 
 

This agreement gives the Center of Southwest Studies ("the Center") permission to reproduce the above described materials for reference use at the Center. Such reproduction may be in the form of photocopying, photoduplication, microform, digitization, or other form which faithfully reproduces the Materials. The Lender also gives the Center permission to perfect the arrangement of the materials in accordance with standard archival principles, the chief of which being provenance and respect for the original order of the materials. There are no restrictions as to the use of the reproductions, except those encompassed by the Center's General Restriction Policy and any specific restrictions specified hereafter:
 
 
 
 
 
 

The Lender hereby gives and assigns to the Center of Southwest Studies or retains all rights of copyright which the Lender has in the reproduced Materials.

Lender's signature ______________________________________________________ Date_______________

Lender's title (if agent for organization) ___________________________________________________________
 

Acknowledged by ___________________________ for Center of SW Studies Date_________________

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