APPLICATION FOR PERMISSION TO PUBLISH

Applicant:  ___________________________________________________________________________________
Address:    ____________________________________________________________________________________ 
_____________________________________________________________________________________________
_____________________________________________________________________________________________

Telephone / FAX / E-mail: _
Applies for permission to reproduce:					Color	B&W	 Inside	Cover
_________________________________________________________	_____	_____	_____	_____	
_________________________________________________________	_____	_____	_____	_____	
_________________________________________________________	_____	_____	_____	_____	

In the following publication:
Title:			________________________________________________________________________
Publication:		________________________________________________________________________
Author:			________________________________________________________________________
Periodical name:		________________________________________________________________________
Publisher and address:	________________________________________________________________________
			________________________________________________________________________
Expected date of publication, volume, year:   ________________________________________________________

Check all that apply:	Commercial  _____	Book               _____        Dissertation _____
			Non profit    _____	Periodical         _____       Textbook     _____
			Advertising   _____	Exhibit catalog   _____     Other ____________________

Distribution rights desired (one time use, one language)
North American rights ____	World rights _____	Language ______________________
Other use: ____________________________________________________________________________________

CREDIT LINE MUST READ:   U.S. Department of the Interior, National Park Service, 
			        Saint-Gaudens National Historic Site, Cornish, NH
___________________________________________________________________________________________

The applicant agrees that this permission is subject to the conditions listed on the reverse of this form and further agrees to promptly pay all applicable fees.

Please complete, sign, and return both copies, attention: Rights & Reproductions. A countersigned copy will be returned to you when permission is granted.

Signature of applicant: _____________________________________________________  Date: _______________
Print name and title:    __________________________________________________________________________

Signed for Saint-Gaudens NHS: ______________________________________________ Date: _______________
Name and title:   _______________________________________________________________________________

CONDITIONS UNDER WHICH REPRODUCTION RIGHTS
ARE GRANTED FOR PHOTOGRAPHS FROM THE COLLECTION
OF SAINT-GAUDENS NATIONAL HISTORIC SITE

1.	All requests for permission to reproduce an image for publication must be made in writing, and include
 	the intended use, the publisher, and expected date of publication.

2.	The publisher is to provide Saint-Gaudens NHS with two complete, gratis copies of the publication in 		which the image is reproduced. Send attention "Rights and Reproductions."

3.	Permission is granted for one time use as detailed on the application form.  Permission  to publish must 	
	be obtained in advance for each subsequent edition or reprint.

4.	Reproduction is permitted only from prints or transparencies supplied by the Site. Color reproductions 
	must be made from a 4 x 5 inch, or larger transparency.	

5.	All negatives and color transparencies remain the property of Saint-Gaudens NHS.

6.	Each image must be reproduced unaltered and in its entirety, unless approved in advance by the 			Superintendent, Saint-Gaudens NHS.  The reproduction must not be cropped, bled off the page, nor 		have anything superimposed on the image.  When a detail is used, the word DETAIL, must appear in 	
	the credit line.

7.	Full documentation credit, AS SUPPLIED BY SAINT-GAUDENS NHS, must appear in immediate 		proximity to the image, or in the section devoted to photographic credits.  Abbreviations are not 			permitted.

8.	Saint-Gaudens NHS assumes no responsibility for any royalties or fees claimed by the artist or 			photographer, or on his/her behalf.
		
9.	Saint-Gaudens NHS reserves the right to deny permission to reproduce an image from its collection to 	
	any applicant whose product is not acceptable to the Site for any reason.

10.	Failure to pay the required fees for reproduction means that permission has not been granted.

11.	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 of the 		Superintendent, Saint-Gaudens NHS.

12.	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.

13.	If so requested, a proof must be approved by the Superintendent, Saint-Gaudens NHS before 			reproduction of an image in color.

	PROOF MUST BE APPROVED:    _____ Yes      _____ No