Woodson Research Center, MS 44, P.O. Box 1892, Rice University Houston, Texas 77251-1892 713-348-2586 713-348-6172 (fax) www.rice.edu/fondren/woodson Email:

Request for Permission to Publish WRC Materials

Conditions for publication:

o Applicant will provide written proof of permission from copyright holder (or satisfy WRC copyright research requirements) and will hold harmless WRC against all claims, demands, costs, and expenses incurred by copyright infringement arising from all reproductions.

o All published reproductions of WRC materials must specifically identify the published materials and bear the following credit line: Courtesy Woodson Research Center, Fondren Library, Rice University.

o A copy of any publication (in any medium) containing reproductions of WRC

materials should be sent upon publication to Woodson Research Center.

o WRC must be assured that the proposed publication will result in a representative presentation of the original. Superimposition of text, cropping, bleeding, addition of color or other alterations are not allowed.

o It is the policy of WRC to assess a use fee for the publication of items from its collections. WRC reserves the right to judge whether a proposed publication is commercial, based on the nature of the publication, the publisher, and the intended circulation. Use fees are for one-time, single- edition rights, and are in addition to any reproduction costs.

Use Fees:

Publication Type / Rice community / Non-profit / Commercial
Print & non-web publications (books, pamphlets, journals posters, cards, videos, dvds, films) / No charge / $25 / $100
Web-only publications / No charge / $15 / $100
Exhibits / No charge / No charge / $50

Proposed publication:

Author/producer:

Title:

Publisher/Agency:

Intended use: (Number & nature of copies to be published / intended

web site / dates & location of exhibit):

Intended audience:

Materials to be published:

Collection number / Box number / Folder number / Call number

Warning Concerning Copyright Restriction

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 by 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, and 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 a violation of copyright law. If reasonable efforts to contact the copyright holder failed, the user is responsible in the event that the copyright holder makes a future claim.

Statement of responsibility: I certify that the information on this sheet is correct, and that any publication of the requested materials will meet the above conditions established by WRC. I understand that no photoduplications may be published without written permission of WRC, and that no copies will be made of the materials provided. Further, I am aware of my responsibility in the case of possible copyright infringement.

Applicant signature: Date:

Telephone:

Applicant name and address [please print]:

To be completed by WRC:

Permission to use the indicated reproduction(s) in the above mentioned publication is granted, subject to payment of a use fee of

WRC Archivist:

Date:

Please return completed and signed form to the Woodson Research Center for authorization.

Form reviewed 06/15