Self-serve photography application
Please complete the form below and bring it to the consultation desk for validation.
We will make a green copy for you.
| Name | First name:User can enter their first name in this location | Last name:User can enter their last name in this location |
|---|---|---|
| User card number | User can enter their 14-digit user card number in this location | |
| Authorization period | From:User can enter their requested authorization "from" date in this location | To:User can enter their requested authorization "to" date in this location |
List of items you'd like to photograph
Shaded fields to be filled out by staff.
| Item number | Reference No. | Restrictions (contractual or ATIP only) |
Verified by |
|---|---|---|---|
| 1. | Reference number | Any restrictions | Name of staff member who verifying this information |
| 2. | Reference number | Any restrictions | Name of staff member who verifying this information |
| 3. | Reference number | Any restrictions | Name of staff member who verifying this information |
| 4. | Reference number | Any restrictions | Name of staff member who verifying this information |
| 5. | Reference number | Any restrictions | Name of staff member who verifying this information |
| 6. | Reference number | Any restrictions | Name of staff member who verifying this information |
| 7. | Reference number | Any restrictions | Name of staff member who verifying this information |
| 8. | Reference number | Any restrictions | Name of staff member who verifying this information |
Terms governing the reproduction and use of material from the collection of Library and Archives Canada (LAC)
Users agree not to use records from LAC collections in a manner that would infringe on the rights of others.
|
Signature:Signature location |
Date:Date location |