Missouri Valley Special Collections
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ORDER FORM
Name
Address
City
State
Zipcode
Phone
Email
Please choose what type of order you would like to complete:
Low-Resolution Digital File
High-Resolution Digital File (Personal, non-profit, government use)
High-Resolution Digital File (Commercial, for-profit use)
Photo #1
Title
Location
Barcode
   
Photo #2
Title
Location
Barcode
   
Photo #3
Title
Location
Barcode
   
Photo #4
Title
Location
Barcode
   
Photo #5
Title
Location
Barcode
   
Additional Photos?

Photo #1
Title
Location
Barcode
   
Photo #2
Title
Location
Barcode
   
Photo #3
Title
Location
Barcode
   
Photo #4
Title
Location
Barcode
   
Photo #5
Title
Location
Barcode
   
Additional Photos?

Photo #1
Title
Location
Barcode
   
Photo #2
Title
Location
Barcode
   
Photo #3
Title
Location
Barcode
   
Photo #4
Title
Location
Barcode
   
Photo #5
Title
Location
Barcode
   
Additional Photos?

Photo #6
Title
Location
Barcode
   
Photo #7
Title
Location
Barcode
   
Photo #8
Title
Location
Barcode
   
Photo #9
Title
Location
Barcode
   
Photo #10
Title
Location
Barcode
   
Photo #6
Title
Location
Barcode
   
Photo #7
Title
Location
Barcode
   
Photo #8
Title
Location
Barcode
   
Photo #9
Title
Location
Barcode
   
Photo #10
Title
Location
Barcode
   
Photo #6
Title
Location
Barcode
Photo #7
Title
Location
Barcode
Photo #8
Title
Location
Barcode
Photo #9
Title
Location
Barcode
Photo #10
Title
Location
Barcode
Intended Use
Personal Use/Research
Educational Use
Exhibit/Display
Television/Video
Publication (print)
Publication (web/digital)
Presentation/Lecture
Other
Description of proposed use.

Please include the title and type of publication, project, presentation or exhibit.
Note: The Missouri Valley Special Collections department requests a copy of all publications in which our images appear.
Low-Resolution Fees:
Patrons are welcome to download and use low resloution images from our website at no charge. However, we ask that you properly credit the Department if the images are to be displayed: Missouri Valley Special Collections, Kansas City Public Library, Kansas City Missouri. Donations to Missouri Valley Special Collections are welcome.
Fees:
Number of High Resolution Images:
Delivery:
x $10

x $25

E-mail (free)
CD - Pickup ($2)
CD - Mailed, First-Class ($4)
Total:
 
Payment Method:
 
Check / Money Order *
Credit Card (MasterCard, American Express, Visa)
* Make checks payable to the Kansas City Public Library and mail to: Kansas City Public Library, Missouri Valley Special Collections, 14 W. 10th Street, Kansas City, MO 64105
Permission and Use
  This authorizes the publication and use of the requested digital images for the purpose specified. Permission is granted in accordance with the following conditions.

The applicant understands and agrees:

  1. To use images once for publication and only for the purpose listed in the "Intended Use" portion of this form. Any subsequent or different use requires a separate order or permission.
  2. Not to reproduce, resell or permit others to reproduce the image or any facsimile of it.
  3. Not to give the image to another library, archives, historical society or other such agency.
  4. To credit each reproduction using the following citation: Missouri Valley Special Collections, Kansas City Public Library, Kansas City, Missouri.
  5. To accept responsibility regarding questions of copyright or invasion of privacy that may arise in use of the material.

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 materials. Under certain conditions specified in the law, libraries and archives are authorized to furnish a photocopy or other reproduction. One of these specified conditions is that the photocopy or other 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 other 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 reproduction order if, in its judgment, fulfillment of that order would involve violation of copyright law.

These conditions are approved and agreed to by the applicant when s/he submits this electronic form to the Missouri Valley Special Collections department of the Kansas City Public Library.

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