- Museum of the History of Science - http://www.mhs.ox.ac.uk -

Photographic Services Order Form

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 [1]):

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 [2] governing the Museum's photographic services.