PLEASE NOTE: This form is used to request image files for photographs, maps, etc. To order a photocopy or scan of an article or other text document, please submit the Copy Request Form instead. Your Name * Address City State Zip Code Phone Number Email Please choose your order Order Type * Low-Resolution Digital File - Free High-Resolution Digital File (Personal, non-profit, government use) - $10 per image High-Resolution Digital File (Commercial, for-profit use) - $25 per image Intended Use of Image(s) * e.g. research, publication, blog post, decor, etc. Provide as much detail as you like Image #1 Image Title * Image Barcode * The barcode is an 8-digit ID number located in the record for every item in the collection. Image #2 Image Title Image Barcode Image #3 Image Title Image Barcode Image #4 Image Title Image Barcode Image #5 Image Title Image Barcode More ImagesAdd more images to your orderImage #6 Image Title Image Barcode Image #7 Image Title Image Barcode Image #8 Image Title Image Barcode Image #9 Image Title Image Barcode Image #10 Image Title Image Barcode PaymentYou may pay either with check/money order or credit card. For online credit card payments, you will receive a link to the payment site after submitting this form. 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. Payment Method * Check / Money Order Credit Card (MasterCard, American Express, Visa) None (for low-resolution images) Permission & Use Permission and UseThis 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: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.Not to reproduce, resell or permit others to reproduce the image or any facsimile of it.Not to give the image to another library, archives, historical society or other such agency.To credit each reproduction using the following citation: Missouri Valley Special Collections, Kansas City Public Library, Kansas City, Missouri.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.