REPRODUCTION REQUEST FORM

35mm slide to slide copies or 35mm slide to print copies.
FEE: $5.00 per slide (covers handling/service fee, cost of copy, and postage).
Payment must accompany postal mailed request form & be sent to:
Reference Department
Michigan City Public Library
100 E. 4th Street
Michigan City, IN   46360
Make check or money order payable to Michigan City Public Library.

SLIDE #(s):

 

NAME (please print): 

 

ADDRESS (please print):

 

Email:          ______________________
Phone:         ______________________
Signature:    ______________________
Date:            ______________________

LIBRARY USE ONLY:

Fee Paid (check box) Request Taken By ________ To Store On________ (date) By________(initials)

 Slide to Slide

Slide to Print