Digitization Permission Request
1000 Rim Dr., Durango, C 81301-3999
Phone: 970-247-7456      Fax: 970-247-7422
Website: http://swcenter.fortlewis.edu/    Email: archives@fortlewis.edu /

The Center's images--other than those covered by the General Restriction Policy Statement and any specific restrictions--are accessible to the public, subject to the Center's prior granting of written permission for use as designated on this form, and subject to restrictions of federal copyright law and/or any collection-specific stipulations.  These conditions apply to all formats of the images, including but not limited to digital/ electronic, photographic, microfilm, and xerographic photoreproduction.  This form is to be completed before any of the Center's images are electronically copied or used by any entity other than the Center of Southwest Studies itself.  Generally, the Center does not permit others to digitize the Center's collection, but rather provides this service itself, using form SW-4.

To access the contents of this document:

Conditions of use Limitations / Copyright notice Use fee schedule User information
  Digitization request User's agreements and instructions Staff records

CONDITIONS OF USE:
The user agrees:
1. to use the specified images only once and then only for the purpose stated on this form, and

2. to wear white cotton gloves at all times whenever handling any photos at the Center, and

3. to maintain the images in their present order and arrangement, and

4. to offer the Center a master TIFF digital file of any  image(s) digitized, and

5. to credit each individual reproduction to: Fort Lewis College Center of Southwest Studies, [name of collection], [image file number], and

6. to make advance payment to the Center of any use fees, and

7. not to use or authorize others to use the image for any purpose differing from the specific use stated below without written permission from the Center of Southwest Studies, and

8. to provide the Center, at the Center's request, a complimentary copy of any publication or production using a Center image(s).


LIMITATIONS:
The Center of Southwest Studies reserves the right to limit the number of images digitized: to restrict the use or reproduction of rare, valuable, or fragile items; to ensure that the use of the reproductions is in good taste; to make special quotations on items involving unusual difficulty in copying; and to charge a higher cost than specified for reproduction of a small number of special items. The Center reserves the right to require a proof for approval before publication.

NOTICE:  WARNING CONCERNING COPYRIGHT RESTRICTIONS
The copyright law of the United States (Title 17, United States Code) governs the making of photocopies or other reproductions of copyrighted material.  Under certain conditions specified in the law, libraries and archives are authorized to furnish a photocopy or other reproduction.  One of these specified conditions is that the photocopy or reproduction is not to be "used for any purpose other than private study, scholarship, or research."  If a user makes a request for, or later uses, a photocopy or reproduction for purposes in excess of "fair use," that user may be liable for copyright infringement.  This institution reserves the right to refuse to accept a copying order if, in its judgment, fulfillment of the order would involve violation of copyright law.


USE FEES       Per image, per use, per edition.             Please mark the appropriate category.
These fees are in addition to reproduction, handling, and mailing fees.

Use fee discounts:

A.  By any not-for-profit or government agency and by the authors of articles in scholarly journals/magazines/newsletters, teaching tools, videotapes, posters, reports, display, or similar use Describe:___________________________________________________           $10.00    ____  

B.  In a book, guide, brochure, or similar use  Describe:________________________________
1-5000 copies $15.00 25,001-30,000 copies $115.00
5001-10,000 copies $35.00 30,001-40,000 copies $135.00
10,001 -15,000 copies $55.00 40,001-50,000 copies $155.00
15,001-20,000 copies $75.00 50,001-60,000 copies $175.00
20,001-25,000 copies $95.00 60,001-70,000 copies $195.00

C.  In a published serial.  Serial title/ date:__________________________________________
1-10,000 copies $15.00 30,001-40,000 copies $60.00
10,001-20,000 copies $30.00 40,001-50,000 copies $75.00
20,001-30,000 $45.00 50,001-60,000 copies $90.00

D.  In a DVD, CD, or videotape   Describe:________________________________________
1-1000 copies $35.00 3001-4000 copies $90.00
1001-2000 copies $55.00 4001-5000 copies $105.00
2001-3000 copies $75.00 5001-8000 copies $120.00

 


E.   Postcards, posters, T-shirts, calendars, mouse pads and/or other non-paper items.   Describe:___________________________________________________________________

1-500 copies

$20.00

2501-3000 copies

    $120.00

501-1000 copies $40.00 3001-3500 copies $140.00
1001-1500 copies $60.00 3501-4,000 copies $160.00
1501-2000 copies $80.00 4001-4500 copies $180.00
2001-2500 copies $100.00 4501-5000 copies $190.00

USER INFORMATION:

NAME______________________________________________ PHONE #_________________
                    Surname                                     First                      Middle

ADDRESS____________________________________________________________________
                                Street/ P.O. Box                                                              City                                 State                Zip Code

INSTITUTIONAL AFFILIATION___________________________________________________


DIGITIZATION REQUEST:

I request permission to digitize the following image(s).  I have noted each item's identifying number and/or brief description. (Continue on an attached page if necessary.)

Collection Name, Collection Number, Item # and/or Negative #, and image description

 _______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________


USER'S AGREEMENTS AND INSTRUCTIONS: 

I agree to use the digital image(s) only once and then only for the following stated purpose:

 

Any special instructions:

 

Signature on this form constitutes agreement to comply with the conditions of use stated on this form.

Signature of User____________________________________________ Date_________________


{BELOW IS FOR STAFF USE ONLY}

USE FEE(S): $__  .__. (payable to: Fort Lewis College)    DATE CHECK RECEIVED: __/___/___

TOTAL PAYMENT DUE: $_______.____ ..........                             AMOUNT PAID: $________.____

SW-59


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Center of Southwest Studies

Page last modified: October 30, 2006