Name* First Last Email* PhoneOrganizationType of BusinessPlease SelectNon-ProfitCommercialAddress* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Use:*Check all that apply Personal Publication Film / Video Website Presentation Display Exhibition OtherPlease Specify Use*Publication DetailsType of Publication*Check all that apply Advertising Book Periodical Dissertation Exhibit CatalogPublication Title*Author(s)PublisherProposed Date of PublicationFilm / Video DetailsFilm / Video Title*ProducerWebsite DetailsWebsite* Presentation DetailsPlace of Presentation*Date of Presentation*Display DetailsDisplay Location*Exhibition DetailsExhibition Title*Exhibition Dates*ConditionsThe Chapman Museum reserves the right to deny permission to reproduce an image from its collection due to rarity or condition, or should the applicant's use not be acceptable to the Museum for any reason.All photo reproduction orders must be PRE-PAID in accordance with the current fee schedule.The Chapman Historical Museum will receive one complimentary copy of the publication in which its image(s) appear.Each image must be reproduced unaltered and in its entirety unless approved in advance, in writing, by the Chapman Museum.The credit "Chapman Museum" must accompany each image in printed format, including publicity and advertising material.For film, video and slide presentations, "Chapman Museum" must be acknowledged in the credits.For exhibition and display, the label must carry the credit "Chapman Museum."Seneca Ray Stoddard images must be credited with the additional line, "S.R. Stoddard Collection."For website use, digital images will be reproduced at 72 dpi, unless otherwise permitted in writing.Permission to publish is for one-time use only. Any subsequent use must be requested in writing and will be subject to current use fees.Permission is valid only for the individual, company, or institution to whom it is specifically issued and may not be transferred, assigned, sold, or otherwise disposed of without written permission.The Chapman Museum assumes no responsibility for any royalties or fees claimed by the artist or photographer, or on his/her behalf.In the case where copyright is held by a third party, written permission must be secured by the applicant from that party or their agent, and must accompany the application.Once your request has been approved, you will receive a confirmation and an invoice for your order.Consent* I agree to the conditions, credits, and fees outlined for this requestNameThis field is for validation purposes and should be left unchanged.