Please complete one form for each different object. Identification Details Object’s Inventory number (five digit number): Description: If there is more that one image of the object available, please insert the URL of the image that you want (from the museum collections pages): If above details are unknown please list source or other identifying information: Type of Media Requested Digital image on CD-ROMDigital image via web transferA4 colour print (inkjet) Type of Permission Rights Required Type of publication: Printed publicationElectronic publicationInside publicationTelevisionacademicCover usesOther uses, inc. advertising Distribution: Single countryWorld one languageWorld multi-language Full details of publication in which photograph will appear: Production run: Applicant’s Details Your Name (required) Your Institution/Department if applicable Your Address(required) Your Email address (required): Billing Details Same address Party to be billed (required) VAT No.: Email: Agreement In submitting this form I agree to the terms and conditions governing the Museum's photographic services.