Publication Quality/Media Request Form

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You will receive an email confirmation for this form. If you do not receive a confirmation, please resubmit the form.

You will receive an email from Authorize.net with instructions on how to pay the request within 3 business days of submission.

Permission only requests should be directed to cah.photos@austin.utexas.edu.

Email *

Name *

Organization

Street address

City

State

Zip code

Phone number *

Delivery timeline:

Turnaround is normally 4-5 weeks. If you need materials sooner, contact the Duplication Department at: cah.photos@austin.utexas.edu .

Name of entity paying for the request *

Status of entity paying for the request *

Current UT system faculty - staff - student

Individual person

Non-profit organization

Commercial organization working for a non-profit

Commercial organization

This request is being made within the state of Texas. *

Yes

This order is tax exempt. I am providing the TEXAS SALES AND USE TAX EXEMPTION form 01-339.

Please email the form to cah.photos@austin.utexas.edu .

I am tax exempt and will provide a tax exempt form.

Material requested

Please provide information describing the material requested the best you can. If you have supporting material, such as images, that will help us locate the images, email them to cah.photos@austin.utexas.edu .

First item requested:

Please provide details describing the image requested preferably including collection name, box/call number location, and identifier if available.

Second item requested:

Third item requested:

Fourth item requested:

Fifth item requested:

Sixth item requested:

If you need additional items, please submit additional requests.

Total number of items requested: *

Additional comments

Optional:

Intended use: The Briscoe Center is interested in how our materials are used and may wish to promote such uses. If you are interested in sharing your purpose please let us know how these images will be used.

Copyright Concerns Agreement

*Please note: the Briscoe Center does not hold the copyright to most items in its collections. Clearance of copyright is always the responsibility of the person wishing to publish or display material. Patrons are responsible for securing permission to reproduce materials either from the DBCAH or from other copyright holders and for complying with copyright laws. Please direct questions about copyright to the Photo Services Coordinator.

I WILL DEFEND, INDEMNIFY, AND HOLD HARMLESS THE DOLPH BRISCOE CENTER FOR AMERICAN HISTORY, THE UNIVERSITY OF TEXAS AT AUSTIN, AND THE UNIVERSITY OF TEXAS SYSTEM, ITS BOARD OF REGENTS, ITS OFFICERS, EMPLOYEES AND AGENTS AGAINST ALL CLAIMS, DEMANDS, COSTS, AND EXPENSES, INCLUDING WITHOUT LIMITATION, ATTORNEYS’ FEES, INCURRED AS A RESULT OF ALLEGED OR ACTUAL COPYRIGHT INFRINGEMENT OR ANY OTHER LEGAL OR REGULATORY CAUSE OF ACTION ARISING FROM THE USE OF THE DOLPH BRISCOE CENTER FOR AMERICAN HISTORY MATERIALS TO THE EXTENT THAT THE LAWS OF THE U.S. AND TEXAS ALLOW.

I agree.

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