Name:  __________________________________________________

Institutional Affiliation (if any):  __________________________________________________

Address:  ____________________________________________________________

City:  _________________________     State:  __________     Zip:  _______________

Email:  __________________________________________________

Home Telephone:  _________________________

Work Telephone:  _________________________

Materials Requested:  __________________________________________________

Purpose of Research:  __________________________________________________

Publication Plans:  __________________________________________________

  1. I have read and agree to abide by the Archives Rules and Procedures.
  2. I also agree that if I choose to publish any material, in any format, from the Archives' collections, now or later, I will obtain written permission from the Archivist prior to publication and abide by the following conditions.
  3. If permission is granted to publish, the source must be acknowledged in the work with the credit line "Hamilton College Archives".
  4. I will forward to the Hamilton College Library a complimentary copy of any publication in which the Archives' material is used.
  5. I realize that I am responsible for conforming to copyright, right-to-privacy, libel, slander, and any other applicable federal and state statutes. I agree to indemnify and hold harmless Hamilton College, its officers, employees, and agents from any and all claims resulting from the use of the materials. I understand that failure to comply with these rules may result in the denial of access to the collections in the future.

Signature:  _____________________________________________     Date:  __________________

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