License for Use

Caldwell Public Library

268 Bloomfield Avenue

Caldwell, New Jersey 07006

 

License for Use of Reproductions

 

Request for Reproductions / Application for Permission to Publish

 

Name of Applicant______________________________________________________________________

 

Organization or Agency__________________________________________________________________

 

Address_______________________________________________________________________________

 

City/State/Zip__________________________________________________________________________

 

Email_________________________________________________________________________________

 

Telephone_____________________________________________________________________________

 

INTENDED USE OF MATERIAL (check one)

 

__­­___These materials are for personal research and will not be copied, reproduced, or publicly displayed.

_____These materials will be reproduced. (Fill out information below)

 

Author/Director/Producer_________________________________________________________________

 

Title or Description of  use ________________________________________________________________

 

______________________________________________________________________________________

 

Publisher______________________________________________________________________________

 

Projected Date of Publication______________________________________________________________

 

Format________________________________________________________________________________

 

Estimated Size of Edition_________________________________________________________________

 

Archival Materials to be Used:_____________________________________________________________

 

_____________________________________________________________________________________

 

________________________________________________________________________

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

 

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An online exhibit of photographs from the Caldwell Public Library's Gene Collerd Local History Collection

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