Columbus State University Archives

Reproduction Request Form

NOTICE: WARNING CONCERNING COPYRIGHT RESTRICTIONS

The copyright law of the United States (Title 17, U. S. 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 reproductions. 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 copy order if, in its judgment, fulfillment of the order would involve violation of the copyright law.

Conditions

1. Reproductions will be made only for use in research, teaching, or private study. They may not be made for or donated to other repositories and may not be further reproduced without permission from the CSU Archives.

2. The user must secure permission in advance from the CSU Archives to publish any item in any way, in whole or in part, from its collections.

3. The user agrees to give proper acknowledgment to the CSU Archives by use of the following credit line: Columbus State University Archives, Columbus State University, Columbus, Georgia.

4. Columbus State University Archives does not claim to control the rights of reproduction for all materials in the collection. The user assumes all responsibility for clearing reproduction rights and for any infringement of the U.S. Copyright Code and agrees to indemnify and hold harmless Columbus State University, its officers, employees, and agents from and against all suits, claims, actions, and expenses.

I have read and agree to the conditions above.

Name (print): ______Signature: ______

Address: ______

______

______

Email: ______Telephone Number: ( ) ______

Scan

Format / Resolution / Price
Low Resolution
Scan (JPG or PDF only) / 300 dpi / $1.00 (per image)
High Resolution
Scan / 600 dpi + / $3.00 (per image)

Audio Digitization

Format / Price
Convert cassette to digital audio (MP3) / $10.00 per hour (minimum .5 hour)

Delivery Method

Format / Price
Email or Google Drive* / No charge
Postage and Handling / $3.00
CD/DVD / $5.00
Printed / $0.25 Black and White (per page)
$1.00 Color (per page)

Service Requested

Method of ☐ Low Resolution Scan ☐ Digital Audio
Reproduction: ☐ High Resolution Scan
Format: ☐ PDF ☐ JPG ☐ TIFF
☐ Printed (black and white) ☐ Printed (color)
Scan Resolution: ☐ 300 dpi ☐ 600 dpi Other ______
Delivery Method: ☐ CD ☐ DVD ☐ Pick up
☐ Mail ☐ Email ☐ Google Drive*

* Google Drive folders will be accessible for 30 days. You must download your requested material before that time.

Items Requested

Collection # / Series # / Box # / Folder # / Item Description / Special Instructions

Return this form via mail or email to:

Columbus State University Archives

Simon Schwob Library

4225 University Ave.

Columbus, Georgia 31907

For Internal Use

Received by: ______Date: ______Payment Received: ☐ Completed: ☐