Person/ Organization giving the Center of Southwest Studies permission to reproduce items loaned to the Center ("Lender") for reproduction:

NAME(s): __________________________________________________________________________________

ADDRESS: _________________________________________________________________________________
                        (Street or P.O. Box)                                          (City)                       (State)                (Zip)

PHONE:  (______) ______ __________             Email: ____________________________________________

Accession number of the Center's reproduction(s):  200___: ___________  

DESCRIPTION OF MATERIALS LOANED TO THE SOUTHWEST STUDIES CENTER 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 and by the Center.  Such reproduction may be in the form of photocopying, photoduplication, microfilming, digitization, display online (including website), or other form that 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:

Lender's signature __________________________________________     Date_______________

Lender's title (if agent for organization)  _______________________________________________

Acknowledged by ___________________ for Center of Southwest Studies     Date______________

 
Donor information

Center of Southwest Studies