Permission to Publish or Display

Permission is requested by _____________________________to reproduce the following item(s) owned by the Center for Pacific Northwest Studies for the possible purpose of publication or display.

Document(s)Description:__________________________________________________

______________________________________________________________________

The applicant intends to use the this reproduction for the following purpose:

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The applicant agrees that permission, if granted, will be subject to the following conditions:

• Unless otherwise stated, the applicant must use the following credit line in display and/or publication: Collection title, Center for Pacific Northwest Studies, Western Washington University, Bellingham WA, 98225-9123.

• Permission is for one-time use only. Applicants may not use reproductions in subsequent editions or in any other form of publication or display without the submission and approval of a new application. Applicants may not edit, crop, overprint, or otherwise alter reproductions. The CPNWS must approve any partial use of a reproduction and the credit line must acknowledge partial use.

• Documents, photographs and other material owned by CPNWS may be protected by copyright or a related interest not owned by the CPNWS. It is the responsibility of the applicant to determine whether any such rights exist, and to obtain the necessary permission for use.

• A fee of $50 for each item will be assessed for any for-profit use of a reproduction in addition to the cost of reproduction.

• The CPNWS reserves the right to request duplicate copy(s) of the negative(s) Yes____ No____

• Applicant Signature____________________________ Date_____________

• Permission granted by__________________________ Date _____________