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Letter of Agreement

photos@mnm.state.nm.us
(505)476.5092

Your Information:
* Name of Applicant:
Organization or Company:
* Address:
* City, State, Zip:
* Telephone:
* Email:
* Confirm Email:
 
Description of Publishing Project:
* Author(s)/Creator(s):
* Title or Description:
* Publisher/Sponsor:
* Place/Location:
* Publication Date:
* Nature of Project:
Total print run, if applicable:
* Negative numbers for which permission is being requested:
(please enter one number per line)

Statement of Responsibility: I certify that the information on this form is correct and I accept the conditions for reproduction/publication. I am authorized to enter into this agreement on behalf of the above named organization.

 I have read the Conditions for Reproduction/Publication and agree to them.

Permission will be granted via a Letter of Agreement upon receipt of payment.