R.A.R.I.N.
DETAILED INFORMATION REQUEST courtesy Amalyah Keshet, The Israel Museum
Thank you for your recent application for photographic material from the<_____> Museum. In order to process your request, we need to determine what kind(s) of photograph(s), reproduction rights, and fees are involved. Please fill out the following information form in as much detail as possible.
1. Personal Information:
Name
Address
Tel no. Fax no.
Title/ Occupation
Type of business
2. Permission is requested to reproduce the following:
Item: ( ) in Whole ( )in Detail ( ) in Color ( ) B/W
3. You require:
Item: ( ) Color Trans. ( ) 35mm Slide ( ) B/W Print ( ) Color
Print ( ) Print Size: ________
Intended Use of Photographs:
Image to appear as:
( ) interior illustration () cover illustration () inside cover/
frontispiece
() full page ( ) half of page ( ) less than half of page
4. For reproduction in:
( ) Book ( ) Journal ( ) Magazine ( ) Periodical
( ) TV ( )Film ( )Video ( ) Audio-Visual Presentation
( ) CD-ROM ( ) Software ( ) Website and other Multimedia
( ) Advertising Material ( ) Brochure/ Flyer
( ) Product Packaging ( ) CD/ Cassette/ Video cover
( ) Poster, Calendar, Etc.
( ) Exhibition, Exhibition Catalogue
( ) Other (please describe)
Title of Publication/ Program/ Film:
Author/ Director/ Producer/ Designer:
Publisher:
No. of illustrations:
Approx. Date of Publication/ Release:
Quantities for Distribution (print run):
Estimated Price of Publication/ Program/ Film/ Object:
Countries Covered by Distribution:
Languages of Publication/ Program/ Film/ Object:
Please include any other information that may be relevant: