Image Permission Form - Us Antarctic Program Digital Photo Library

This "Image Permission Form - Us Antarctic Program Digital Photo Library" is a document issued by the U.S. National Science Foundation specifically for United States residents with its latest version released on August 1, 2008.

Download the up-to-date fillable PDF by clicking the link below or find it on the forms website of the U.S. National Science Foundation.

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Image Permission Form
US Antarctic Program Digital Photo Library
Use this form to permit the National Science Foundation to use your image.
Fax the completed form to 303.790.9130. We will contact you to arrange to receive
the image(s) by mail or e-mail. Photos may be added to the digital library with NSF
approval.
Agreement
1. I grant the National Science Foundation and its contractor permission to use and distribute,
but not sell, the described image. I understand that anyone who wants to sell the photo for
profit will contact me.
2. I certify that any person who is recognizable in the image has granted to me permission for
the image to be used by the public, including news media.
3. I retain copyright as in NSF’s Grant General Conditions, section 18.
(www.nsf.gov/pubs/policydocs/gc1_607.pdf)
4. NSF or its contractor will post the image on the US Antarctic Program Digital Photo Library
Web site to be available to the public. Anyone, including news media, may reproduce and
use the image.
5. NSF or its contractor will post with the image the photographer’s name, photographer’s insti-
tution if desired, date of photo and caption.
6. NSF will encourage users to credit the photographer, the photographer’s institution if speci-
fied and the National Science Foundation.
I, ____________________________________ understand and agree to the terms of this form.
(Print name)
Signature _____________________________________ Date _________________________
E-mail address _______________________________________________________________
If you are currently a USAP participant, provide a personal e-mail address.
Telephone number ____________________________________________________________
If you are currently a USAP participant, provide an off-Ice phone number where you can be reached in the future.
Photo Information
Please provide basic information about the photo. We will rename the photo and write the caption, but need to
know where the photo was taken, what is going on, who is in the photo and the date taken.
Examples: IM0334.jpg - Calkin Glacier in Taylor Valley, 11/4/07
P40523.jpg - GA Dan Jones shoveling trench at New Harbor, 10/28/06
Image name
Who/what/where
Date Taken
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
eh 08/08
Image Permission Form
US Antarctic Program Digital Photo Library
Use this form to permit the National Science Foundation to use your image.
Fax the completed form to 303.790.9130. We will contact you to arrange to receive
the image(s) by mail or e-mail. Photos may be added to the digital library with NSF
approval.
Agreement
1. I grant the National Science Foundation and its contractor permission to use and distribute,
but not sell, the described image. I understand that anyone who wants to sell the photo for
profit will contact me.
2. I certify that any person who is recognizable in the image has granted to me permission for
the image to be used by the public, including news media.
3. I retain copyright as in NSF’s Grant General Conditions, section 18.
(www.nsf.gov/pubs/policydocs/gc1_607.pdf)
4. NSF or its contractor will post the image on the US Antarctic Program Digital Photo Library
Web site to be available to the public. Anyone, including news media, may reproduce and
use the image.
5. NSF or its contractor will post with the image the photographer’s name, photographer’s insti-
tution if desired, date of photo and caption.
6. NSF will encourage users to credit the photographer, the photographer’s institution if speci-
fied and the National Science Foundation.
I, ____________________________________ understand and agree to the terms of this form.
(Print name)
Signature _____________________________________ Date _________________________
E-mail address _______________________________________________________________
If you are currently a USAP participant, provide a personal e-mail address.
Telephone number ____________________________________________________________
If you are currently a USAP participant, provide an off-Ice phone number where you can be reached in the future.
Photo Information
Please provide basic information about the photo. We will rename the photo and write the caption, but need to
know where the photo was taken, what is going on, who is in the photo and the date taken.
Examples: IM0334.jpg - Calkin Glacier in Taylor Valley, 11/4/07
P40523.jpg - GA Dan Jones shoveling trench at New Harbor, 10/28/06
Image name
Who/what/where
Date Taken
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
eh 08/08

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