PINE MOUNTAIN SETTLEMENT SCHOOL
36 Highway 510 | Pine Mountain, KY 40810
Telephone/Fax 606-558-3571 or 3542
PRINT AND MAIL OR EMAIL ATTACHMENT TO
office@pinemountainsettlementschool.com
COLLECTIONS USE REQUEST: (NON-COMMERCIAL)
While we are pleased to share our material with you, we track the use of images and documents from our collections. To facilitate the tracking of our material use, please complete this form and submit it to PINE MOUNTAIN SETTLEMENT SCHOOL at the above address (digital or mail). We will return this signed release copy for your records.
Date of request: ____________________________
Your Deadline:______________________________
Name of requester: ____________________________________________________________________
Address: __________________________________________________________________
City/State/Zip __________________________________________________________________
Telephone: ______________________________FAX: _________________________________
Email: ____________________________________________________________________
Full disclosure of use: (Describe non-commercial use)
######################################################
Conditions of Use:
Use of material must be granted by the Pine Mountain Settlement School (PMSS). Commercial use requires a separate agreement and may require fees. Commercial use applies to publication by any means and of any material belonging to the School for commercial purposes. This form constitutes a USE REQUEST for NON-COMMERCIAL use only.
Certain items in the collections may retain their copyright. The USER is responsible for determining copyright status. PINE MOUNTAIN SETTLEMENT SCHOOL IS NOT RESPONSIBLE FOR COPYRIGHT INFRINGEMENT BY THE USER.
Suggested citation: [Item name, Collection, Series information, date, location information. Pine Mountain Settlement School Collections.] A photograph, for example: Chapel interior (chap_1234.jpg), Series: 10, Built Environment. Pine Mountain Settlement School Collections. Pine Mountain, Kentucky.
Release of materials in the collection is at the discretion of the School. PINE MOUNTAIN SETTLEMENT SCHOOL reserves the right to deny permission for the use of or reproduction of any material held in the collections of the school.
Please allow sufficient time to complete your request. RUSH requests may not be honored or may require additional fees as our staff is limited.
USER signature: I have read and agree to the stipulations of this USE AGREEMENT.
___________________________________________________________________________
DATE:_______________________
If you have questions and/or require accommodation regarding this USE AGREEMENT, please describe below or contact
606-558-3571 or 3542
office@pinemountainsettlementschool.com
PMSS STAFF signature: _____________________________________________________________________
DATE: ________________________
**Note on commercial use: A use fee will be charged for material that will be used in the public domain where the intent is profit. Please contact us regarding our fee schedule if you desire to publish or to use Pine Mountain Settlement School materials in a commercial manner.
Signature of PMSS staff ______________________________________________
Date: ___________________
____________
PINE MOUNTAIN SETTLEMENT SCHOOL COLLECTIONS
36 Highway 510 | Pine Mountain, KY 40810
Telephone/Fax 606-558-3571 or 3542
