Application form for photographic reproductions of the Marciana NationalLibrary

To the Director of the Biblioteca Nazionale Marciana, Venezia Photographicreproduction office

I, the undersigned ... ... ask for the following photographic reproductionsto be realised at the expenses of ... ...

The requested reproductions are:

MICROFILM 35 mm
PHOTOCOPY FROMMICROFILM
MICROFILM AND PHOTOGRAPHICPRINTS (cm 13x18; 18x24; 30x40)
PROFESSIONAL PHOTOGRAPHICREPRODUCTIONS IN B/W FROM NEGATIVE 6x7 (cm 13x18; 18x24; 30x40)
COLOUR SLIDES 24x36mm
COLOUR SLIDES FORPUBLISHING PURPOSES (cm 6x7; 10x12; 13x18)

The delivery support will be:

First class mail
Regular mail
Courier
FAX

Address: ...
Phone: ...
FAX: ...

taxpayer's code ... ... VAT number ... ...
Date ...
Signature ...


Such reproductions will be used for the following purpose (study, culturalpreservation, to be annexed to graduation dissertations, publication ina volume, etc.): ... ...

NB. The requests will be accepted unless the office for photographic reproductionsdisagrees. If negatives or colour photographs already exist, the reproductionwill be realised from them and not from the original document.
The reproductions are for study purposes; however, if the reproduction isfor a publication, then it is necessary to fill in the formfor permission to publish too.

Information about the documents to be reproduced (call number, author,title, type of requested reproduction):