Morris Museum of Art -

IMAGE REQUEST FORM

•Name
•Title
•Company
•Address

•City
•State		•Zip Code

•Country

•Phone

•Fax

•E-mail

•Image(s) you are requesting:

•Type of format you are requesting:
35mm color slide digital file	4x5 color transparency Other

•Image Use:
Scholarly: a museum publication in connection with an exhibition, use by a student or lecturer for study, lecture or dissertation
Nonprofit: non-scholarly use by an organization with a 501 (C) 3 status
Commercial: all other uses

•Publication/Use:
Print Media (interior) Cover Image Exhibition Panel Video	Film Web site CD-ROM •Other

•Title of Publication

•Date of Publication

•Please list any further details, explanations or requests: