Confirm use * I confirm this is a request of images for use in film (broadcast or television), or for inclusion in a mobile application. See conditions for general use. Organization designation * We are a for-profit organization (commercial studio, organization or individual.) We are a non-profit organization (academic institution, museum, USA 501(c)(3)-501(c)(4) nonprofit or international equivalent organization.) Organization information Institution name Contact person Mailing address Email address Phone number Please include the area code. Requested Photographs or Archive ObjectsAdd item Artist name CCP accession number Image title and date Service needed Scan only (written permission of copyright holder required) Permission only (source of scan must be noted in “Other Information”) Scan and Permission (CCP-owned or managed copyrights only) Add item Artist name CCP accession number Image title and date Service needed Scan only (written permission of copyright holder required) Permission only (source of scan must be noted in “Other Information”) Scan and Permission (CCP-owned or managed copyrights only) Add item Artist name CCP accession number Image title and date Service needed Scan only (written permission of copyright holder required) Permission only (source of scan must be noted in “Other Information”) Scan and Permission (CCP-owned or managed copyrights only) Image list If you are requesting many images, please add your image list. Film Project Details Project title Please enter your project title and/or the title of the program. Scheduled airing date and time Total length of program Producer Type of use Broadcast television Cable television Theatrical presentation DVD Video on demand Streaming Other... Type of use Other... Additional use details Provide any additional information about the use such as what network the film would be broadcast on, what channel, planned quantities of DVDs, etc. Language(s) Film distribution market North America Europe Asia World Mobile App Project Details Publisher Title Distribution channel(s) Google Play Apple App Store Windows Phone Marketplace Amazon Appstore Other... Distribution channel(s) Other... Market term 2 years 3 years 5 years Other... Market term Other... Anticipated sales quantity Retail price $ Preferred date of delivery Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20172018201920202021 Does not guarantee your schedule can be met. Other information Please provide any other useful information about your project or course.