REPRODUCTION REQUEST FORM

35mm slide to slide copies ONLY.
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.
Walk-in customers are charged a $3.00 handling/service fee plus the cost of copies. Handling/service fee must be paid at time of request submission. 
Cost of copies must be paid when items are picked up.

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)